Clinical presentation and outcomes of hospitalized adults with COVID‐19: A systematic review

• Published in: Journal of advanced nursing 2020-12, Vol.76 (12), p.3235-3257
• Main Authors: Keller, Kristin Garrett, Reangsing, Chuntana, Schneider, Joanne Kraenzle
• Format: Article
• Language: English
• Subjects: Adult; Adults; Betacoronavirus - isolation & purification; Chronic illnesses; clinical presentation; Coronavirus Infections - pathology; Coronavirus Infections - therapy; Coronavirus Infections - virology; Cough reflex; COVID-19; definitive outcomes; disaster preparedness; Health care; Hospitalization; Hospitalized; Humans; Medical conditions; Medical diagnosis; Nurses; Nursing; Obesity; Observational studies; pandemic; Pandemics; Pneumonia, Viral - pathology; Pneumonia, Viral - therapy; Pneumonia, Viral - virology; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Survival Analysis; Symptoms; Systematic review; Treatment Outcome
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14558

Aims The aims of this review were to: (a) determine the clinical presentation; and (b) outcomes of adult hospitalized patients with COVID‐19 to provide practicing nurses with a cogent and concise clinical impression of COVID‐19 patients. Design We conducted a systematic review of early published, peer‐reviewed, original research where researchers presented data from adult hospitalized COVID‐19 patients regarding their presenting signs, symptoms, and definitive survival outcomes. Data Sources We searched the databases PubMed, CINAHL, and Scopus for relevant articles published between 1 January 2020 ‐18 May 2020. Review Methods We extracted data from each study and synthesized them across primary sources using a literature matrix table to provide a global impression of this rapidly growing body of literature. Results We retrieved 97 mainly descriptive observational studies. SARS‐CoV‐2 is efficiently transmitted between humans, particularly those in close contact. Symptomatic COVID‐19 patients can present with a broad array of nonspecific symptoms. Fever and cough are the most commonly reported symptoms; some patients have atypical presentations. In patients with respiratory decompensation, disease progression can be rapid. Some patients experience mild symptoms that are self‐limited; others experience organ failure and death. Risk factors for poor outcomes include older age, chronic medical conditions, male gender, obesity, and presenting with signs of declining respiratory status. Conclusion Nurses can mitigate the spread of SARS‐CoV‐2 and sequelae of COVID‐19 with prompt and capable responses. Impact This study addresses the problem of the continued spread of SARS‐CoV‐2 while little is known about this virus. This review provides nurses with a summary of the most current evidence regarding the signs, symptoms, and outcomes of adult hospitalized COVID‐19 patients that they might identify COVID‐19 patients rapidly on presentation to medical care and be attuned to indicators of patient decompensation. 摘要 目的 本项系统评价旨在:(a)确定新冠肺炎成人住院患者的临床表现和(b)预后,以便为执业护士提供关于新冠肺炎患者的可信和简明的临床印象。 设计 我们对早期发表的、同行评审的原始研究进行了系统评价,其中,研究人员提供了新冠肺炎成人住院患者的表现症状、体征和最终预后生存的数据。 数据来源 我们在数据库PubMed、CINAHL和Scopus中搜索了2020年1月1日至2020年5月18日期间发表的相关文章。 审查方法 我们从每项研究中提取数据,并利用文献矩阵表对其进行跨主要来源的综合分析,以提供对这一快速增长的文献主体的全局印象。 结果 我们检索了97项主要的描述性观察研究。新型冠状病毒可在人与人之间高效传播,尤其是密切接触者。有症状的新冠肺炎患者可出现一系列广泛的非特异性症状。发热和咳嗽是最常见的症状;部分患者有非典型表现。对于呼吸代偿障碍的患者,疾病进展可能很快。一些患者可能会出现自限性轻微症状;一些患者则出现器官衰竭和死亡。导致预后不良的风险因素包括年龄较大、慢性病、男性、肥胖、出现呼吸状态下降的病征。 结论