Association between symptoms and severity of disease in hospitalised novel coronavirus (COVID-19) patients: A systemic review and meta-analysis

Ashis Talukder, Shaharior Rahman Razu, Sheikh Alif, Muhammad Aziz Rahman, Sheikh Mohammed Shariful Islam

Research output: Other contributionResearch


Background Symptoms of the novel coronavirus disease (COVD-19) are well known, although asymptomatic cases were also reported due to this rapidly evolving viral disease. However, there has been limited research with inconsistent findings on symptoms of COVID-19 and diseases severity. We aimed to evaluate the association between symptoms and severity of disease in confirmed COVID-19 cases by performing a meta-analysis. Methods We conducted a systematic review by searching four online databases (Medline, Web of Science, EMBASE and Cochrane library) of published studies that included symptoms of COVID-19 cases and severity of the disease between 01-Jan-2020 and 20-Apr-2020. PRISMA and MOOSE guidelines were followed, and only articles published in English were selected. We performed meta-analysis using Mantel-Haenszel random-effects model. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results Out of 153 articles identified, a total of seven articles, including 3,168 participants, met the inclusion criteria and were included. The median age of the patients was 49 years, 1818 (57.38%) were males, and 574 (18.11%) reported severe conditions. Fever was the most commonly reported symptom in the reported COVID-19 confirmed cases (87.89%, 95% CI: 83.22–81.39%), which was followed by cough, myalgia or fatigue, and less proportionally dyspnea and headache. Dyspnea was the only symptom, which was associated with severity of COVID-19 (OR 2.38, 95% CI: 1.83–3.10). Conclusions Dyspnoea was found to be associated with severity of COVID-19. People with existing respiratory illnesses, such as chronic obstructive pulmonary diseases need to be careful about the onset of such symptom and should seek medical attention.
Original languageEnglish
PublisherResearch Square
Number of pages12
Place of PublicationDurham NC USA
Publication statusPublished - 27 May 2020

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