Clinical Features of COVID-19 Patients in the first year of pandemic: A Systematic Review and Meta-Analysis

Background:
The new coronavirus disease (COVID-19) carries a high risk of infection and has spread rapidly around the world. However, there are limited data about the clinical symptoms globally. The purpose of this systematic review and meta-analysis is to identify the prevalence of the clinical symptoms of patient with COVID-19.

Methods:
A systematic review and meta-analysis were carried out. The following databases were searched: PubMed, CHINAL, MEDLINE, EMBASE, PsycINFO, MedRxiv and Google Scholar, from December 1st 2019 to January 1st 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics.

Results:
A total of 215 studies, involving132,647 COVID-19 patients, met the inclusion criteria. The pooled prevalence of the 4 most common symptoms were fever 76.2% (n = 214; 95% CI 73.9-78.5); coughing 60.4% (n = 215; 95% CI 58.6-62.1); fatigue 33.6% (n = 175; 95% CI 31.2-36.1); and dyspnea 26.2% (n = 195; 95% CI 24.1-28.5). Other symptoms from highest to lowest in terms of prevalence include expectorant (22.2%), anorexia (21.6%), myalgias (17.5%), chills (15%), sore throat (14.1%), headache (11.7%), nausea or vomiting (8.7%), rhinorrhea (8.2%), and hemoptysis (3.3%). In subgroup analyses by continent, it was found that 4 symptoms have a slight prevalence variation - fever, coughing, fatigue and diarrhea.

Conclusion:
This meta-analysis found the most prevalent symptoms of COVID-19 patients were fever, coughing, fatigue and dyspnea. This knowledge might be beneficial for the effective treatment and control of the COVID-19 outbreak. Additional studies are required to distinguish between symptoms during and after, in patients with COVID-19.