Comparison of confirmed COVID-19 with SARS and MERS cases - Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta-analysis

Rev Med Virol. 2020 Jul;30(4):e2112. doi: 10.1002/rmv.2112. Epub 2020 Jun 5.

Abstract

Introduction: Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features.

Method: We searched all relevant literature published up to February 28, 2020. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Study has been registered in the PROSPERO database (ID 176106).

Result: Overall 114 articles included in this study; 52 251 COVID-19 confirmed patients (20 studies), 10 037 SARS (51 studies), and 8139 MERS patients (43 studies) were included. The most common symptom was fever; COVID-19 (85.6%, P < .001), SARS (96%, P < .001), and MERS (74%, P < .001), respectively. Analysis showed that 84% of Covid-19 patients, 86% of SARS patients, and 74.7% of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 (5.6%, P < .001) was lower than SARS (13%, P < .001) and MERS (35%, P < .001) between all confirmed patients.

Conclusions: At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than in SARS- and MERS-infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and this should be considered when interpreting the data.

Keywords: COVID-19; Middle East respiratory syndrome coronavirus; SARS virus; coronavirus; meta-analysis; severe acute respiratory syndrome.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Betacoronavirus*
  • Blood Cell Count
  • COVID-19
  • China
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / mortality
  • Coronavirus Infections* / physiopathology
  • Cough
  • Dyspnea
  • Female
  • Fever
  • Hospitalization
  • Humans
  • Lung / diagnostic imaging
  • Male
  • Middle East Respiratory Syndrome Coronavirus*
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / physiopathology
  • Risk Factors
  • SARS-CoV-2
  • Severe Acute Respiratory Syndrome* / diagnosis
  • Severe Acute Respiratory Syndrome* / mortality
  • Severe Acute Respiratory Syndrome* / physiopathology
  • Travel