Epidemiological characteristics of COVID-19: a systematic review and meta-analysis
Open Access
- 29 June 2020
- journal article
- review article
- Published by Cambridge University Press (CUP) in Epidemiology and Infection
- Vol. 148, 1-39
- https://doi.org/10.1017/s0950268820001430
Abstract
Our understanding of the Coronavirus disease 2019 (COVID-19) continues to evolve and there are many unknowns about its epidemiology. This study aims to synthesise case fatality rate (CFR) among confirmed COVID-19 patients, incubation period and time from onset of COVID-19 symptoms to first medical visit, intensive care unit (ICU) admission, recovery, and death. We searched MEDLINE, Embase, Google Scholar, and bibliographies of relevant articles from 01 December 2019 to 11 March 2020 without any language restrictions. Quantitative studies that recruited people with confirmed COVID-19 diagnosis were included. Two independent reviewers extracted the data. Out of 1675 non-duplicate studies, 43 were included in the meta-analysis. The pooled mean incubation period was 5.68 (99% confidence interval [CI]: 4.78, 6.59) days. The pooled mean number of days from the onset of COVID-19 symptoms to first clinical visit was 4.92 (95% CI: 3.95, 5.90), ICU admission was 9.84 (95% CI: 8.78, 10.90), recovery was 18.55 (95% CI: 13.69, 23.41), and death was 15.93 (95% CI: 13.07, 18.79). Pooled CFR among confirmed COVID-19 patients was 0.02 (95% CI: 0.02, 0.03). We found that the incubation period and lag between the onset of symptoms and first clinical visit for COVID-19 are longer than other respiratory viral infections including Middle East respiratory syndrome and severe acute respiratory syndrome; however, the current policy of 14 days of mandatory quarantine for everyone potentially exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be too conservative. Longer quarantine periods might be more justified for extreme cases.Keywords
This publication has 81 references indexed in Scilit:
- A Novel Coronavirus from Patients with Pneumonia in China, 2019The New England Journal of Medicine, 2020
- In vitro characterization of root extracellular trap and exudates of three Sahelian woody plant speciesPlanta, 2019
- Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: epidemiology, pathogenesis and clinical characteristics2018
- Methodological quality and synthesis of case series and case reportsBMJ Evidence-Based Medicine, 2018
- PRESS Peer Review of Electronic Search Strategies: 2015 Guideline StatementJournal of Clinical Epidemiology, 2016
- Severe acute respiratory syndrome vs. the Middle East respiratory syndromeCurrent Opinion in Pulmonary Medicine, 2014
- Convincing Evidence from Controlled and Uncontrolled Studies on the Lipid-Lowering Effect of a StatinPublished by Wiley ,2012
- Estimation of the incubation period of influenza A (H1N1-2009) among imported cases: Addressing censoring using outbreak data at the origin of importationJournal of Theoretical Biology, 2011
- Incubation periods of acute respiratory viral infections: a systematic reviewThe Lancet Infectious Diseases, 2009