COVID-19: Main findings after a year and half of unease and the proper scientific progress (Review).

ABSTRACT

Since the emergence of the disease in late December 2019, numerous studies have been published to date regarding clinical, laboratory and treatment aspects associated with COVID-19. The present study attempts to compare and unify the clinical, para-clinical and therapeutic aspects that have come to light regarding coronavirus disease-19 (COVID 19), mainly in adults. Between April 2020 and September 2021, a comprehensive systematic literature review was performed, which we added to from our own medical experiences. The search was performed on the PubMed, Scopus and Google Scholar databases, comprising studies with analyzable data that were identified alongside studies and documents containing general scientific data. All published studies were written in English, and were from different countries. A 95% confidence interval (CI95) was also calculated for almost each study using the Wilson formula. When compared with preliminary reports between December 2019 and January 2020, the most frequent symptoms were still identified as being fever (68.6%; CI95 67.5-69.7) and cough (72.7%; CI95 71.7-73.8). Nevertheless, asymptomatic cases also increased (by 21.4%; CI95 16.6-27.1). Severe and critical cases accounted for 10.4% (CI95 9.6-11.1) of all cases. The mean fatality rate was found to be 4% (CI95 3.6-4.5). The primary co-morbidity found was hypertension (28.9%; CI95 27-30.8), followed by other underlying cardiovascular diseases (15.4%; CI95 13.9-16.9) and diabetes (14.5%; CI95 13.1-16.1). The majority of studies showed lower white blood cell numbers with neutropenia and lymphopenia, and lower platelet levels. The levels of the biomarkers C-reaction protein and erythrocyte sedimentation rate were positive in all studied cases alongside other lab tests, such as examining the D-dimer levels and those of other hepatic, cardiac and renal injury markers. The procalcitonin level was also found to be elevated in many cases, resulting in high usage of antibiotics (83.7%; CI95 81.2-85.9). Approximately 31.6% (CI95 29.1-34.1) of the patients required non-invasive ventilation, whereas 9.9% (CI95 8.1-12.1) of the patients were intubated or placed on extracorporeal membrane oxygenation. The most used antivirals were ribavirin (67.3%; CI95 63.4-70.9), oseltamivir (52.5%; CI95 49.4-55.5) and Arbidol™ (34.5%; CI95 32-37.1). General admittance to the intensive care unit was ~7.2% (CI95 6.5-7.9) of patients.