Clinical and pathological characteristics of 2019 novel coronavirus disease (COVID-19): a systematic reviews

  1. Yaqian Mao
  2. Wei Lin
  3. Junping Wen
  4. Gang Chen

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Abstract

Importance

In 2002-2003, a severe pulmonary infectious disease occurred in guangdong, China. The disease was caused by severe acute respiratory syndrome coronavirus (SARS-CoV), 17 years apart, also happen in China, and also a novel coronavirus (SARS-CoV-2), this epidemic has posed a significant hazard to people’s health both China and the whole world.

Objective

Summarized the latest epidemiological changes, clinical manifestations, auxiliary examination and pathological characteristics of COVID-19.

Evidence Review

PubMed database were searched from 2019 to 2020 using the index terms “novel coronavirus” or “COVID-19” or “2019-nCoV” or “SARS-CoV-2” and synonyms. Articles that reported clinical characteristics, laboratory results, imageological diagnosis and pathologic condition were included and were retrospectively reviewed for these cases. This paper adopts the method of descriptive statistics.

Results

34 COVID-19-related articles were eligible for this systematic review,Four of the articles were related to pathology. We found that Fever (86.0%), cough (63.9%) and Malaise/Fatigue (34.7%) were the most common symptoms in COVID-19. But in general, the clinical symptoms and signs of COVID-19 were not obvious. Compared with SARS, COVID-19 was transmitted in a more diverse way. The mortality rates of COVID-19 were 2.5%, and the overall infection rate of healthcare worker of COVID-19 was 3.9%. We also found that the pathological features of COVID-19 have greatly similar with SARS, which manifested as ARDS. But the latest pathological examination of COVID-19 revealed the obvious mucinous secretions in the lungs.

Interpretation

The clinical and pathological characteristics of SARS and COVID-19 in China are very similar, but also difference. The latest finds of pathological examination on COVID-19 may upend existing treatment schemes, so the early recognition of disease by healthcare worker is very important.

Key Points

Question

What can we learn from the clinical manifestations and pathological features of 2019 novel coronavirus disease (COVID-19)?

Findings

In this review, we found COVID-19 was transmitted in a more diverse way than Severe acute respiratory syndrome (SARS). Fever, cough and Malaise/Fatigue were the most common symptoms. We also found that the SARS-CoV-2 has the same cell entry receptor ACE2 as SARS-CoV, and they have similar pathological mechanisms like Acute respiratory distress syndrome (ARDS).

Meaning

This review aims to give people a more comprehensive understanding of COVID-19 and to continuously improve the level of prevention, control, diagnosis and treatment.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.02.20.20025601: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Institutional review board approval and informed consent were not obtained given that the study was a systematic review of the literature, we limited our study to published information and did not engage with any human subjects.
    Consent: Institutional review board approval and informed consent were not obtained given that the study was a systematic review of the literature, we limited our study to published information and did not engage with any human subjects.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Searches were done in scientific databases of PubMed, based on the combination of related keywords based of Mesh terms (Table 1).
    PubMed
    suggested: (PubMed, RRID:SCR_004846)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.02.20.20025601 on medRxiv