Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis
by
Israel Júnior Borges do Nascimento 1
, Nensi Cacic 2, Hebatullah Mohamed Abdulazeem 3, 
Thilo Caspar von Groote 4,*, Umesh Jayarajah 5, 
Ishanka Weerasekara 6,7, Meisam Abdar Esfahani 8, Vinicius Tassoni Civile 9, Ana Marusic 2, Ana Jeroncic 2, Nelson Carvas Junior 10, Tina Poklepovic Pericic 2, Irena Zakarija-Grkovic 2, Silvana Mangeon Meirelles Guimarães 1, Nicola Luigi Bragazzi 11, Maria Bjorklund 12, Ahmad Sofi-Mahmudi 8, Mohammad Altujjar 13, Maoyi Tian 14,15, Diana Maria Cespedes Arcani 16, 
Dónal P. O’Mathúna 17,18 and Milena Soriano Marcolino 1
Israel Júnior Borges do Nascimento 1, Nensi Cacic 2, Hebatullah Mohamed Abdulazeem 3, Thilo Caspar von Groote 4,*, Umesh Jayarajah 5, Ishanka Weerasekara 6,7, Meisam Abdar Esfahani 8, Vinicius Tassoni Civile 9, Ana Marusic 2, Ana Jeroncic 2, Nelson Carvas Junior 10, Tina Poklepovic Pericic 2, Irena Zakarija-Grkovic 2, Silvana Mangeon Meirelles Guimarães 1, Nicola Luigi Bragazzi 11, Maria Bjorklund 12, Ahmad Sofi-Mahmudi 8, Mohammad Altujjar 13, Maoyi Tian 14,15, Diana Maria Cespedes Arcani 16, Dónal P. O’Mathúna 17,18 and Milena Soriano Marcolino 1
1
University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100, Brazil
2
Cochrane Croatia, University of Split School of Medicine, Split 21000, Croatia
3
Department of Sport and Health Science, Technische Universität München, 80333 Munich, Germany
4
Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Münster, 48149 Münster, Germany
5
Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 00700, Sri Lanka
6
School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan 2308, Australia
7
Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
8
Cochrane Iran Associate Centre, National Institute for Medical Research Development, Tehran 16846, Iran
9
Cochrane Brazil, Evidence-Based Health Program, Universidade Federal de São Paulo, São Paulo 04021-001, Brazil
10
Cochrane Brazil, Universidade Paulista, São Paulo 04057-000, Brazil
11
Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
12
Faculty of Medicine, Lund University, SE-221-00 Lund, Sweden
13
Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USA
14
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales 2052, Australia
15
The George Institute for Global Health, Peking University Health Science Center, Beijing 100088, China
16
Department of Cardiovascular and Thoracic Surgery, Zhongnan Hospital, Wuhan University, Wuhan 430070, China
17
Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, College of Nursing, The Ohio State University, Columbus, OH 43210, USA
18
School of Nursing, Psychotherapy and Community Health, Dublin City University, D04V1W8 Dublin, Ireland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 941; https://doi.org/10.3390/jcm9040941
Received: 5 March 2020 / Revised: 18 March 2020 / Accepted: 23 March 2020 / Published: 30 March 2020
(This article belongs to the Special Issue Real Time Clinical and Epidemiological Investigations on Novel Coronavirus)
A growing body of literature on the 2019 novel coronavirus (SARS-CoV-2) is becoming available, but a synthesis of available data has not been conducted. We performed a scoping review of currently available clinical, epidemiological, laboratory, and chest imaging data related to the SARS-CoV-2 infection. We searched MEDLINE, Cochrane CENTRAL, EMBASE, Scopus and LILACS from 01 January 2019 to 24 February 2020. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers. Qualitative synthesis and meta-analysis were conducted using the clinical and laboratory data, and random-effects models were applied to estimate pooled results. A total of 61 studies were included (59,254 patients). The most common disease-related symptoms were fever (82%, 95% confidence interval (CI) 56%–99%; n = 4410), cough (61%, 95% CI 39%–81%; n = 3985), muscle aches and/or fatigue (36%, 95% CI 18%–55%; n = 3778), dyspnea (26%, 95% CI 12%–41%; n = 3700), headache in 12% (95% CI 4%–23%, n = 3598 patients), sore throat in 10% (95% CI 5%–17%, n = 1387) and gastrointestinal symptoms in 9% (95% CI 3%–17%, n = 1744). Laboratory findings were described in a lower number of patients and revealed lymphopenia (0.93 × 109/L, 95% CI 0.83–1.03 × 109/L, n = 464) and abnormal C-reactive protein (33.72 mg/dL, 95% CI 21.54–45.91 mg/dL; n = 1637). Radiological findings varied, but mostly described ground-glass opacities and consolidation. Data on treatment options were limited. All-cause mortality was 0.3% (95% CI 0.0%–1.0%; n = 53,631). Epidemiological studies showed that mortality was higher in males and elderly patients. The majority of reported clinical symptoms and laboratory findings related to SARS-CoV-2 infection are non-specific. Clinical suspicion, accompanied by a relevant epidemiological history, should be followed by early imaging and virological assay.
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Keywords:
novel coronavirus; SARS-CoV-2; COVID-19; scoping review; meta-analysis
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MDPI and ACS Style
Borges do Nascimento, I.J.; Cacic, N.; Abdulazeem, H.M.; von Groote, T.C.; Jayarajah, U.; Weerasekara, I.; Esfahani, M.A.; Civile, V.T.; Marusic, A.; Jeroncic, A.; Carvas Junior, N.; Pericic, T.P.; Zakarija-Grkovic, I.; Meirelles Guimarães, S.M.; Luigi Bragazzi, N.; Bjorklund, M.; Sofi-Mahmudi, A.; Altujjar, M.; Tian, M.; Arcani, D.M.C.; O’Mathúna, D.P.; Marcolino, M.S. Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis. J. Clin. Med. 2020, 9, 941.
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