Epidemiologic, clinical, and laboratory findings of the COVID-19 in the current pandemic: systematic review and meta-analysis.

BACKGROUND: The COVID-19 pandemic has affected the world deeply, with more than 14,000,000 people infected and nearly 600,000 deaths. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic. METHODS: We scoped for relevant literatures published during 1st December 2019 to 16th July 2020 based on three databases using English and Chinese languages. We reviewed and analyzed the relevant outcomes. RESULTS: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39), the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0 °C), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 °C, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 65 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS: We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.

The Changing Patterns of Coronavirus Disease 2019 (COVID-19) in China: A Tempogeographic Analysis of the Severe Acute Respiratory Syndrome Coronavirus 2 Epidemic.

BACKGROUND: Evaluating whether an infectious disease has reached a turning point is important for planning additional intervention efforts. This study aimed to analyze the changing patterns and the tempogeographic features of the coronavirus disease 2019 (COVID-19) epidemic in China, to provide further evidence for real-time responses. METHODS: Daily data on COVID-19 cases between 31 December 2019 and 26 February 2020 were collected and analyzed for Hubei and non-Hubei regions in China. Observed trends for new and cumulative cases were analyzed through joinpoint regression analysis. Spatial analysis was applied to show the geographic distribution and changing patterns of the epidemic. RESULTS: By 26 February 2020, 78 630 confirmed COVID-19 cases had been reported in China. In Hubei, an increasing trend (slope = 221) was observed for new cases between 24 January and 7 February 2020, after which a decline commenced (slope = -868). However, as the diagnosis criteria changed, a sudden increase (slope = 5530) was observed on 12 February, which sharply decreased afterward (slope = -4898). In non-Hubei regions, the number of new cases increased from 20 January to 3 February and started to decline afterward (slope = -53). The spatial analysis identified Chongqing, Guangzhou, Shenzhen, Changsha, Nanchang, Wenzhou, Shanghai, Xinyang, Jining, and Beijing as the hotspots outside of Hubei Province in China. CONCLUSIONS: The joinpoint regression analysis indicated that the epidemic might be under control in China, especially for regions outside of Hubei Province. Further improvement in the response strategies based on these new patterns is needed.

Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic.

BACKGROUND: The COVID-19 caused the pandemic affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths. This article aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of COVID-19 pandemic. METHODS: We scoped for relevant literatures published during 1st Dec 2019 to 23rd Apr 2020 based on four databases by using English and Chinese. The evidence was synthesized narratively. RESULTS: The COVID-19 pandemic was found to have a higher transmission rate compared to SARS and MERS, and involved 4 stages of evolution. The basic reproduction number (R0) is 3.32 (95% CI:3.24-3.39) and the incubation period was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset varied by countries. Common clinical spectrums identified included fever (38.1-39.0°C), cough and fatigue, with Acute Respiratory Distress Syndrome (ARDS) being the most common complication reported. Body temperatures above 39.0 °C, dyspnea, and anorexia were more common symptoms in severe patients. Aged over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity were the most frequent CT results and the tendency of mortality rates differed by region. CONCLUSIONS: We provided a bird's-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease. The findings could be used for disease's future research, control and prevention.

Differentiating COVID-19 Response Strategies.

Globally, the COVID-19 pandemic brings different challenges to the impacted countries. To combat this pandemic, different strategies need to be tailored and implemented in countries with different situations. First, in countries with an ongoing explosion of the outbreak (i.e. the USA, Spain, and Italy), strategies suggested by the World Health Organization (WHO) which have been proven useful in China should be adopted for implementation. Secondly, countries in the regions that are still at the early stages of the outbreak (i.e., the Africa region, where many countries have only found imported cases) should further strengthen travel restrictions to reduce the risk of imported cases as well as the risk of developing local transmission. Furthermore, countries that have achieved great success in COVID control (i.e. China, South Korea, and Singapore) should continue implement the successful strategies and further roll-out strengthened new strategies to prevent new imported cases. In addition, surveillance on the genomic changes of SARS-CoV-2 is in need in all countries as some studies have found multiple mutants of SARS-CoV-2, although the impact of the mutation on the infectivity and lethality of the virus was still unclear.