key: cord-0732641-aoi4iqkf
authors: Sun, Pengfei; Qie, Shuyan; Liu, Zongjan; Ren, Jizhen; Jianing Xi, Jianing
title: Clinical characteristics of 50466 patients with 2019-nCoV infection
date: 2020-02-23
journal: nan
DOI: 10.1101/2020.02.18.20024539
sha: 9bf1677e5f822110e736076a4ba6960a80f2f348
doc_id: 732641
cord_uid: aoi4iqkf

Objective: We aim to summarize reliable evidences of evidence-based medicine for the treatment and prevention of the 2019 novel coronavirus (2019-nCoV) by analyzing all the published studies on the clinical characteristics of patients with 2019-nCoV. Methods: PubMed, Cochrane Library, Embase, and other databases were searched. Several studies on the clinical characteristics of 2019-nCoV infection were collected for Meta-analysis. Results: Ten studies were included in Meta-analysis, including a total number of 50466 patients with 2019-nCoV infection. Meta-analysis shows that, among these patients, the incidence of fever was 89.1%, the incidence of cough was 72.2%, and the incidence of muscle soreness or fatigue was 42.5%. The incidence of acute respiratory distress syndrome (ARDS) was 14.8%, the incidence of abnormal chest computer tomography (CT) was 96.6%, the percentage of severe cases in all infected cases was 18.1%, and the case fatality rate of patients with 2019-nCoV infection was 4.3%. Conclusion: Fever and cough are the most common symptoms in patients with 2019-nCoV infection, and most of these patients have abnormal chest CT examination. Several people have muscle soreness or fatigue as well as ARDS. Diarrhea, hemoptysis, headache, sore throat, shock, and other symptoms only occur in a small number of patients. The case fatality rate of patients with 2019-nCoV infection is lower than that of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

2.2.2 Exclusive criteria: articles were published repeatedly; studies did not include the research indicators needed for Meta-analysis; research data were missing.

First of all, we screened the literature according to the literature abstract, excluding the articles that obviously do not meet the inclusive criteria, and then read the full article for re-screening. If any disagreement on the choice of the literature exists, a third evaluator will join to make the decision. All included literature were evaluated using The statistical software Stata version 12.0 was used to carry out the single arm Meta-analysis. Original data included in the literature were first transformed by double arcsine method to make them conform to normal distribution and then analyzed in Stata. The initial conclusion obtained by Meta-analysis was then restored using formula (P=(sin(tp/2)) 2 ) to reach final conclusion. In order to objectively evaluate the publication bias of the included literature, the Egger test with P < 0.05 as the existence of publication bias was performed, the values larger than which were considered as no publication bias.

A total of 284 articles were retrieved, among which 39 papers were removed due to repeated retrieval, 212 papers were removed after reading abstracts, 23 were eliminated after reading the full text. At the end, a total of 10 articles [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] were included in this Meta-analysis, including data from 50466 patients. The specific operation flow is shown in Figure 1 . The characteristics of the literature are shown in Table 1 .

Through Meta-analysis, we found that among all the clinical characteristics of patients with 2019-nCoV infection, the incidence of fever was 89.1% (Figure 2 ), that of cough was 72.2% (Figure 3 ), and that of muscle soreness or fatigue was 42.5% ( Figure 4 ). The incidence of ARDS was 14.8% ( Figure 5 ), correspondingly that of abnormal chest CT detection was 96.6% ( Figure 6 ), severe cases in all infected cases occupied a percentage of 18.1% Table 2 .

The results of Egger test in Table 3 . There was publication bias in the Meta-analysis of the ARDS group(P=0.008)..

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The copyright holder for this preprint found that 2019-nCoV was only closely related to the coronavirus isolated from chrysanthemum-headed bat in 2015. Their research suggests that bats may be the reservoir host for 2019-nCoV. According to the research by Peng Zhou et al. [18] and Fan Wu et al. [19] , it was found that the sequence homology between 2019-nCoV and SARS-CoV was 79.5%. The homology between 2019-nCoV and bat coronavirus at the genetic level was 96%.

Therefore, very likely it can be confirmed that 2019-nCoV comes from bats.

According to the results of Meta-analysis, we find that the most common symptoms of patients with 2019-nCoV infection were fever and cough, and most of the patients had abnormal chest CT. Some patients with 2019-nCoV infection had muscle soreness or fatigue, ARDS, and other symptoms. Diarrhea, hemoptysis, headache, sore throat, .

CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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The copyright holder for this preprint shock, and other symptoms only occurred among a small number of patients. The proportion of severe cases in all infected cases was 18.1%, and the case fatality rate was 4.3%. At present, the Chinese government has announced that the case fatality rate of patients with 2019-nCoV infection in China is 3.36%, which is lower than that of another two widely contagious zoonotic coronavirus diseases, SARS and MERS. Infection mortality rates of SARS and MERS are 9.6% [20] and 35% [21] , respectively.

Gaohong Sheng et al. [22] have shown that viral infection could increase the risk of pulmonary fibrosis. Xie et al. [23] found that 45% of patients showed signs of pulmonary fibrosis within one month after being infected with SARS-CoV. Hui et al. [24] revealed that 36% and 30% of patients infected with SARS-CoV developed pulmonary .

It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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The copyright holder for this preprint Yu Zhao et al. [25] found that angiotensin converting enzyme 2 (ACE2) was the receptor of 2019-nCoV. In normal lung tissue, ACE2 is mainly expressed by type and type alveolar epithelial cells. .

It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

is the

The copyright holder for this preprint It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

is the

The copyright holder for this preprint .

It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

is the

The copyright holder for this preprint 

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