Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 12, Number 4, April 2020, pages 215-229

COVID-19, Modern Pandemic: A Systematic Review From Front-Line Health Care Providers’ Perspective

Figures

Figure 1.
Figure 1. Number of patients, average age and age range.
Figure 2.
Figure 2. Male and female ratio.
Figure 3.
Figure 3. Clinical signs and symptoms.
Figure 4.
Figure 4. Temperature in centigrade at presentation.
Figure 5.
Figure 5. Laboratory and radiological findings.
Figure 6.
Figure 6. Course of hospitalization.

Tables

Table 1. Group Staging Based on Chest CT Findings From a Retrospective Study on 81 Patients
 
GroupsDuration of symptomsCT chest findings
CT: computed tomography.
Group 1SubclinicalUnilateral ground-glass opacities
Group 2Less than 1 weekBilateral ground-glass opacities
Group 31 - 2 weeksDecrease in ground-glass opacities
Group 42 - 3 weeksConsolidation and mixed patterns

 

Table 2. Studies Discussing About Comorbid Conditions and Mortality
 
StudyNumber of patients (n)Co-morbid conditionsMortality
HTN: hypertension; DM: diabetes mellitus; CVD: cardiovascular disease; CKD: chronic kidney disease; NA: not available.
Guan et al [31]1,099HTN: 165 (15%)
CVD: 27 (2.5%)
DM: 81 (7.4%)
CKD: 8 (0.7%)		15 (0.4)
Huang et al [14]41HTN: 6 (15%)
CVD: 6 (15%)
DM: 8 (20%)
CKD: NA		6 (15%)
Chen et al [15]99HTN: NA
CVD: 40 (40%)
DM: 12 (12%)
CKD: NA		11 (11%)

 

Table 3. MuLBSTA Score
 
For in-hospital mortality, score 0 - 11 is low risk, score greater than or equal to 12 is high risk.
Multilobar infiltrate5 points
Lymphocyte count less than 0.8 × 109/L4 points
Bacterial coinfection4 points
Acute smoker3 points
Hypertension2 points
Age greater than or equal to 602 points

 

Table 4. Classification of Disease Based on Signs, Symptoms and Imaging
 
Yu-Huan Xu et al classification
  MildMild clinical symptoms, no imaging presentation of pneumonia
  CommonFever, respiratory symptoms, imaging confirming pneumonia
  SevereRespiratory distress with a respiratory rate greater than 30, oxygen saturations < 93% at rest and PaO2/FiO2 < 300
  Critically severeRespiratory failure with intubation, shock, organ failure requiring care in intensive care unit
Tian et al classification
  Non-pneumoniaConfirmed case with fever and/or respiratory symptoms, but no radiographic evidence of pneumonia
  MildConfirmed case with fever, respiratory symptoms and radiographic evidence of pneumonia
  SevereMild case with dyspnea and respiratory failure

 

Table 5. Potential Therapeutic Options for COVID-19
 
DrugMechanism of actionDose and frequencyMode of administration
Vitamin A, B, C, D, E, thymosin alpha-1, thymopentinAntioxidants/enhance immunityOral
Selenium, zinc and pyrithione combinationEnhance immunityOral
Interferon-βInhibit the replication of SARS-CoV and MERS-CoV replicationSub-cutaneous
Interferon-αInhibit the replication of SARS-CoV and MERS-CoV replication5 million U twice a day for a maximum of 10 daysInhalation
ChloroquineSpike (S)-protein angiotensin-converting enzyme 2 (ACE-2) blockers500 mg twice daily for a maximum of 10 daysOral
MefloquineUnknownN/AOral
FavipiravirRNA-dependent RNA polymerase (RdRp) inhibitorProposed dose, 600 mg tid with 1,600 mg first loading dosage for a maximum of 14 daysOral
RemdesivirRdRp inhibitor200 mg on day 1 followed by 100 mg daily for 9 daysIntravenous
DarunavirProtease inhibitor800 mg dailyOral
Lopinavir/ritonavirProtease inhibitor200 mg/50 mg, two capsules twice a day for a maximum of 10 daysOral
RibavirinNucleoside analogue500 mg, 2 to 3 times per dayIntravenous infusion in combination with lopinavir/ritonavir + interferon-α
Arbidol200 mg three times a day for a maximum of 10 daysOral
Type II transmembrane serine protease (TMSPSS2) inhibitors (Brand - Camostat)TMSPSS2 inhibitorsOral

 

Table 6. Model From Wuhan, China
 
R0: metric in epidemiology used to describe the transmissibility of infectious agents; Rt: reproduction number at a particular point of time.
Phase 1An early phase of the epidemic when few prevention and control measures were implemented. R0 was 3.1.
Phase 2Public transportation to and from Wuhan, as well as public transportation within Wuhan, were stopped. While gathering events inside Wuhan was banned, quarantine and isolation were gradually established in Wuhan. Rt was 2.6.
Phase 3New infectious disease hospitals and mobile cabin hospitals came into service, and many medical and public health teams from other provinces and cities in China arrived in Wuhan. The quarantine and isolation at the community level were further enhanced. Rt decreased to 1.9.
Phase 4The peak of public health restrictions in Wuhan, China. Rt became 0.9.