Clinical Presentation and Outcomes of Hospitalized Adults with COVID-19: A systematic review.

Keller, Kristin Garrett; Reangsing, Chuntana; Schneider, Joanne Kraenzle

AIMS The aims of this review were to 1) determine the clinical presentation and 2) outcomes of adult hospitalized patients with COVID-19 to provide practicing nurses with a cogent and concise clinical impression of COVID-19 patients. DESIGN We conducted a systematic review of early published, peer-reviewed, original research where researchers presented data from adult hospitalized COVID-19 patients regarding their presenting signs, symptoms and definitive survival outcomes. DATA SOURCES We searched the databases PubMed, CINAHL and Scopus for relevant articles published between 1 January 2020 - 18 May 2020. REVIEW METHODS We extracted data from each study and synthesized data across primary sources using a literature matrix table to provide a global impression of this rapidly growing body of literature RESULTS: We retrieved 97 mainly descriptive observational studies. SARS-CoV-2 is efficiently transmitted between humans, particularly those in close contact. Symptomatic COVID-19 patients can present with a broad array of nonspecific symptoms. Fever and cough are the most commonly reported symptoms; some patients have atypical presentations. In patients with respiratory decompensation, disease progression can be rapid. Some patients experience mild symptoms that are self-limited; others experience organ failure and death. Risk factors for poor outcomes include older age, chronic medical conditions, male gender, obesity and presenting with signs of declining respiratory status. CONCLUSION Nurses can mitigate the spread of SARS-CoV-2 and sequelae of COVID-19 with prompt and capable responses. IMPACT This study addresses the problem of the continued spread of SARS-CoV-2 while little is known about this virus. This review provides nurses with a summary of the most current evidence regarding the signs, symptoms and outcomes of adult hospitalized COVID-19 patients that they might identify COVID-19 patients rapidly on presentation to medical care and be attuned to indicators of patient decompensation.