Clin Exp Otorhinolaryngol.  2020 Apr;13(2):95-105. 10.21053/ceo.2020.00570.

The Clinical Manifestations and Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Patients in China: A ProportionMeta-Analysis

• Park JH
• Jang W
• Kim SW
• Lee J
• Lim YS
• Cho CG
• Park SW
• Kim BH

• KMID: 2500281
• DOI: http://doi.org/10.21053/ceo.2020.00570

Abstract

Objectives
. The objectives of this study were to identify the clinical features and chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) patients and to compare the characteristics of patients diagnosed in Wuhan and in other areas of China by integrating the findings reported in previous studies.
Methods
. We conducted a proportion meta-analysis to integrate the results of previous studies identified in online databases, and subsequently compared the overlapping of 95% confidence intervals (CIs) between locations of diagnosis. The heterogeneity of the results of the included studies was also demonstrated.
Results
. Nine studies with level IV evidence were considered to be eligible for the meta-analysis, and a comparative analysis was only possible between patients diagnosed in Wuhan and outside of Wuhan in China. Fever (84.8%; 95% CI, 78.5% to 90.1%) was identified as the most common clinical manifestation in all COVID-19 patients, and signs of respiratory infection were also frequently present in these patients. When comparing the clinical features according to the location of diagnosis, fever and dyspnea were less frequent in patients diagnosed outside of Wuhan (fever: 78.1%; 95% CI, 73.2% to 82.7%; dyspnea: 3.80%; 95% CI, 0.13% to 12.22%) than in patients diagnosed in Wuhan (fever: 91.7%; 95% CI, 88.0% to 94.8%; dyspnea: 21.1%; 95% CI, 13.2% to 30.3%). The chest CT findings exhibited no significant differences between the groups.
Conclusion
. Fever was found to be the most common symptom in COVID-19, and respiratory infection signs were also commonly present. Fever and dyspnea were less frequently observed in the patients diagnosed outside of Wuhan, which should be considered in COVID-19 screening programs. These results may be attributable to the earlier diagnosis of the disease and the younger age of patients outside of Wuhan although further analysis is needed. The role of chest CT in COVID-19 diagnosis is inconclusive based on this study.

Keyword

COVID-19; 2019-nCoV; 2019 Novel Coronavirus; Meta-analysis; Infectious Disease

Figure

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  Fig. 1. Flowchart of the final inclusion of studies. Nine studies were found to be eligible for the meta-analysis [33-41], extracted from 783 abstracts and titles.

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  Fig. 2. The proportions of symptoms in coronavirus disease 2019 (COVID-19) patients extracted from nine studies [33-41]. The proportions of fever (A), cough (B), dyspnea (C), and gastrointestinal symptoms (D). CI, confidence interval.

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  Fig. 3. Comparison of the proportions of symptoms between patients diagnosed in Wuhan and outside of Wuhan in China [33-41]. Significant differences were noted in the proportion of patients with fever (A) and dyspnea (B). CI, confidence interval.

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  Fig. 4. The proportions of pathologic patterns observed on chest computed tomography (CT) in patients with coronavirus disease 2019 (COVID-19) [33-41]. The proportions of patients with ground-glass opacity (A) and consolidation (B). GGO, ground-glass opacity; CI, confidence interval.

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  Fig. 5. The proportions of the distribution of pathologic findings observed on chest computed tomography in patients with coronavirus disease 2019 (COVID-19) [33-41]. The proportions of single lobe involvement (A), multiple lobe involvement (B), and bilateral lung involvement (C). CI, confidence interval.

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