The Clinical Manifestations and Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Patients in China: A Proportion Meta-Analysis
The Clinical Manifestations and Chest Computed Tomography Findings of Coronavirus Disease 2019 (COVID-19) Patients in China: A Proportion Meta-Analysis
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DOI：
10.21053/ceo.2020.00570
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发表时间：
2020-05-01
影响因子：
3
通讯作者：
Kim, Bo Hae
中科院分区：
文献类型：
--
作者：
Park, Joo-Hyun;Jang, Wook;Kim, Bo Hae
目标.本研究的目的是确定2019冠状病毒病（COVID-19）患者的临床特征和胸部计算机断层扫描（CT）结果，并通过整合既往研究报告的结果，比较武汉和中国其他地区确诊患者的特征。我们进行了一项比例荟萃分析，以整合在线数据库中识别的先前研究的结果，随后比较了诊断位置之间95%置信区间（CI）的重叠。还证明了纳入研究结果的异质性。结果。9项IV级证据的研究被认为有资格进行荟萃分析，并且只能在中国武汉和武汉以外地区诊断的患者之间进行比较分析。发热（84.8%; 95%CI，78.5%至90.1%）被确定为所有COVID-19患者中最常见的临床表现，这些患者中也经常出现呼吸道感染体征。当根据诊断地点比较临床特征时，发热和呼吸困难在武汉以外诊断的患者中较不常见（发热。78.1%; 95%CI，73.2%~ 82.7%;呼吸困难：3.80%; 95%CI，0.13%~ 12.22%）高于武汉确诊患者（发热：91.7%; 95%CI，88.0%~ 94.8%;呼吸困难：21.1%; 95%CI，13.2%~ 30.3%）。两组患者的胸部CT表现差异无统计学意义。发热是COVID-19最常见的症状，呼吸道感染体征也普遍存在。在武汉以外地区确诊的患者中，发热和呼吸困难的发生率较低，应在COVID-19筛查项目中予以考虑。这些结果可能归因于疾病的早期诊断和武汉以外患者的年轻化，尽管需要进一步分析。基于这项研究，胸部CT在COVID-19诊断中的作用尚不确定。
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 he 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.