Clinical Characteristics of Coronavirus Pneumonia 2019 (COVID-19): An Updated Systematic Review

Zhangfu Fang; Fang Yi; Kang Wu; Kefang Lai; Xizhuo Sun; Nanshan Zhong; Zhigang Liu

Actually, we have learned from the SARS outbreak 17 years ago that early identification, early isolation and early management would lead to the stop of viral transmissions from human to human 79 . Collectively, there were 36% of the COVID-19 patients absent from fever as the onset symptom. In this case, such patients may have been ignored at the early stage if we focused heavily on fever examination for initial screening. Our composite analysis showed that fever remains the most common symptom (83.0%) in patients with COVID-19. However, the proportion of fever is somewhat lower than that of other coronavirus related respiratory illness, such as SARS (100%) 80 81 or middle east respiratory syndrome (MERS) (98%) 82 . Similarly, the accompanied symptoms of dyspnea (14.5%) and diarrhea (6.1%) are relatively less common in patients with COVID-19 than those seen in SARS and MERS 87 . More importantly, this study revealed an overall CFR of 3.7%, which was quite similar to that reported by the WHO official statistics as of March 5, 2020 (CFR 3.7%, 3,015 died of 80,565 cases) 4 . Nevertheless, the CFR of COVID-19 was much lower than that of SARS (9.6%) 83 and MERS (37.1%) 84 . By far, the mechanisms underlying the varying symptoms and CFR for these three coronavirus-infected diseases are not fully understood. One reason may be that there were still some COVID-19 patients being treated in hospitals at the time of the manuscripts submitted, so the outcome (death or recovery) is not known yet.