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\begin{document}

\title{Exploration of severe Covid-19 associated risk factor in China:
meta-analysis of current evidence}



\author[1]{Yun-Jing Zhang}%
\author[1]{Xi-Feng Sun}%
\author[1]{Bing Xie}%
\author[2]{Wen-Juan Feng}%
\author[3]{Shi-liang Han}%
\affil[1]{Zibo Central Hospital}%
\affil[2]{Jinan Central Hospital Affiliated to Shandong University}%
\affil[3]{Affiliation not available}%


\vspace{-1em}



  
  \date{March 14, 2025}


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\selectlanguage{english}
\begin{abstract}
Methods: We systemically and comprehensively retrieved the eligible
study evaluating clinical difference between severe versus non-severe
Covid-19. Main effect sizes were demography characteristics,
comorbidities, signs and symptoms, laboratory findings as well as
radiological features in chest CT. Results: 14 studies with a total of
2,566 individuals (771 in Severe group and 1,795 in Non-severe group)
were eligible for this meta-analysis. It was demonstrated that older and
male person was more susceptible to severe Covid-19. Patients with
underlying comorbidity, such as hypertension, diabetes, heart disease
and COPD were associated with significantly increased susceptibility of
severe Covid-19. Patients with dyspnea were more likely to be severe
illness. Depressed total lymphocytes were observed in this article.
Meanwhile, although reticulation (30.8\%), intrathoracic lymph node
enlargement (56.4\%) and pleural effusions (30.8\%) were relatively
rarely seen, meta-analysis revealed that patients with these
presentations in chest CT were associated with increased risks of severe
Covid-19. Conclusions: There are significant differences in clinical
characteristic between the severe and non-severe Covid-19 patients. Many
factors are related to the severity of the disease, which can help
clinicians to differentiate severe patient from non-severe patient.%
\end{abstract}%



\sloppy


\textbf{Statistical analysis}

Meta-analysis was performed on crude data extracted from the text. We
calculated the weighted mean difference (WMD) for continuous outcomes
and the odds ratio (OR) for the dichotomous data, along with the 95\%
confidence intervals (CIs). In instances in which a standard error was
not reported, we calculated the standard error of mean differences
according to the methods described in Cochrane Handbook{[}13{]}.

Prior to analyzing the data, heterogeneity was assessed by the Cochran Q
test along with visual inspection of the forest plot. Then, it was
quantified by \emph{I\textsuperscript{2}} test. A fixed-effect model was
used when the effects were assumed to be homogenous (P\textgreater{}0.05
or \emph{I\textsuperscript{2}} \textless{}50 \%){[}13{]}. However, given
that the clinical settings differed across studies, we assumed the
presence of heterogeneity and used random-effects model in all
subsequent analyses, for the outcome of which were more conservative as
they consider differences both within and among studies in calculating
the error term used in the analysis{[}13{]}.

Funnel plots were employed for detection of publication bias, in which
the effect sizes (e.g., OR or WMD) are plotted on the horizontal axis
and its variance (e.g., the standard error of the log effect) on the
vertical axis. Bias was revealed if the plots were asymmetrical about
the pooled value.

All statistical analyses were done with Review Manager 5.3.5 (Cochrane
Collaboration, Oxford, UK). Results were regarded as statistically
significant if P\textless{}0.05.

\textbf{Result}

\textbf{Trial flow}

The search strategy generated a total of 6,821 citations (3,516 from
Pubmed and 3,205 from ISI web of science). All the documents were
selected strictly according to the criteria described above. Subsequent
scrutiny of the title and abstracts led to the exclusion of 6,777 of
these articles either for they were irrelevant to the aim of this
meta-analysis or for duplication. 21 articles were further excluded for
un-relation to our aim. The full publications were obtained for the
remaining 23 articles.

According to inclusion criteria, 9 articles were further excluded,
leaving 14 studies eligible for this article{[}14-27{]}. Specially, two
articles were excluded either for overlapping patients with included
studies{[}3{]}, or for they defined the degree of severity of Covid-19
with the different criteria{[}3, 28{]}. One article reporting outcome
regarding 55 2019-nCoV was also excluded from this meta-analysis, since
it did not reported origin of patients{[}29{]}. For three articles
reporting outcome in Wuhan Tongji hoptital{[}17, 30, 31{]}, three
articles reporting outcome in Jiangsu Province{[}27, 32, 33{]} and three
article reporting outcome in Zhejiang province{[}33-35{]}, only the
study with larger simple volume was in included in this article{[}17,
27, 33{]}. No additional articles were retrieved from the citation list
of included studies. The details of study selection flow were explicitly
described in Figure 1.

\textbf{Study characteristics}

Finally, 14 retrospective cross-sectional studies regarding different
population which can be concluded from patients' origin were suitable
for this meta-analysis{[}14-27{]}: four multi-center studies{[}19-21,
27{]} and ten single-center studies{[}14-18, 22-26{]}. All the eligible
studies were from China and published in 2020. Due to the instinct
design of this meta-analysis, no randomized or non-randomized controlled
trial was eligible for this meta-analysis. Characteristics of eligible
studies were shown in Table 1.

\textbf{The demography}

A total of 2,566 individuals were identified (771 in Severe group and
1,795 in Non-severe group) {[}14-27{]}. Specially, there were 12 studies
reporting 409 males in 747 patients in Severe group (54.8\%) and 843
males in 1,724 in Non-severe group (48.9\%) {[}14-17, 19-25, 27{]}. With
the pooled OR of 1.30 (95 \% CI: 1.07 to 1.57), it was demonstrated that
males were associated with significantly increased susceptibility of
severe Covid-19. Consistently, of 14 studies reporting age of
patients{[}15-27{]}, it was revealed that older individuals were more
susceptible to severe Covid-19 (WMD: 11.12, 95 \% CI: 6.70 to 15.55).
The outcome was explicitly expressed in Table 2.

\textbf{Comorbidity}

In 7 eligible trials{[}15-17, 19, 22-24{]}, hypertension was noted in
166 of 497 patients in Severe group (33.4\%) and 151 of 973 in
Non-severe group (15.5 \%). With pooled OR of 2.30 (95 \% CI: 1.35 to
3.92), it was demonstrated that patients with hypertension were
associated with significantly increased risk of severe Covid-19
(P=0.002). Consistently, with pooled OR of 2.62 for diabetes (95\%CI:
1.27 to 5.44, P=0.009), 4.02 for heart disease (95\%CI: 2.08 to 7.77,
P\textless{}0.0001) and 4.20 for chronic obstructive pulmonary disease
(95\%CI: 1.61 to 10.95, P=0.003), it was revealed that patients with
diabetes{[}15-17, 19, 22-24{]}, heart disease{[}15-17, 19, 22-24{]} and
chronic obstructive pulmonary disease{[}15, 17, 22, 24, 27{]} were more
susceptible to severe Covid-19. Conversely, with pooled OR of 1.81 for
cerebrovascular disease (95\%CI: 0.56 to 5.84, P=0.32), 1.28 for chronic
live disease (95\%CI: 0.60 to 2.71, P=0.53), 2.12 for chronic kidney
disease (95\%CI: 0.80 to 5.61, P=0.13) and 2.69 for tuberculosis
(95\%CI: 0.66 to 10.97, P=0.17), it was demonstrated that patients with
cerebrovascular disease{[}17, 25{]}, chronic live disease{[}17, 19, 24,
27{]}, chronic kidney disease{[}17, 19, 24, 27{]} and tuberculosis{[}17,
25{]} were not associated with increased risk of severe Covid-19. What's
more, smoke{[}17, 19, 22, 24{]} did not statistically increased risk of
severe Covid-19 (OR: 1.07, 95\%CI: 0.40 to 2.85, P=0.90).

Overall, 4 trials reported any comorbidity{[}17, 21, 22, 24{]} with 226
of 398 patients in Severe group (56.8\%) and 137 of 430 in Non-severe
group (31.9\%). With pooled OR of 3.61 (95\% CI: 1.62 to 8.01), it was
revealed that individuals with comorbidity were more susceptible to
severe Covid-19 (P=0.002). The outcome was explicitly expressed in Table
2.

\textbf{Signs and symptoms}

Among 9 studies{[}15, 17, 20, 22, 23, 25-27{]} reporting the clinical
characteristics of fever in Covid-19, the incidence was 93.1\% (552 in
593) in Severe group and 83.1\% (795 in 957) in Non-severe group. With
pooled OR of 1.93 (95\%CI: 0.94 to 3.96), it was demonstrated severe
Covid-19 patient was associated with slightly increased risk of fever.
But meta-analysis did not reveal any statistical difference (P=0.07).
Consistently, with pooled OR of 1.79 for expectoration (95\%CI: 0.79 to
4.05, P=0.17), 1.43 for headache (95\%CI: 0.91 to 2.26, P=0.12), 1.75
for fatigue (95\%CI: 0.89 to 3.44, P=0.11) and 2.22 for myalgia (95\%CI:
0.65 to 7.52, P=0.20), it was demonstrated that patients with
expectoration{[}15, 17, 22, 23{]}, headache{[}15, 17, 20, 22{]},
fatigue{[}16, 17, 20, 25{]} and myalgia{[}15, 17, 27{]} were unrelated
to severity of Covid-19.

In 5 trials reporting data on dyspnea{[}15, 20, 22, 23, 25{]}, 82 of 192
patients in Severe group (42.7\%) and 52 of 477 in Non-severe group
(10.9\%) were found to have dyspnea. With pooled OR of 7.83 (95 \% CI:
1.75 to 34.99), it was demonstrated that patients with dyspnea were more
likely to progress into severe Covid-19 too (P=0.007). The outcome was
explicitly expressed in Table 2.

\textbf{Laboratory findings}

Of 7 studies reporting data on blood tests, lymphocyte count was
revealed in all 7 studies{[}15, 17, 18, 22, 23, 26, 27{]}. With pooled
WMD of -0.42 (95 \% CI: -0.64 to -0.20), it was revealed that severe
Covid-19 case was more likely to have decreased lymphocyte count when
compared with non-severe case (P=0.0002). However, no significant
difference was found in leucocytes{[}15, 17, 22, 23, 27{]},
neutrophils{[}15, 17, 22, 23, 26, 27{]} and monocyte count{[}15, 17,
27{]}. The outcome was explicitly expressed in Table 2.

\textbf{Imaging features}

Among 5 studies reporting data on chest CT{[}15, 21, 22, 25, 27{]}, the
incidence of bilateral pneumonia was 95.8\% (162 in 219) in Severe group
and 73.4\% (378 in 515) in Non-severe group. With pooled OR of 1.48
(95\%CI: 0.50 to 4.35), it was demonstrate severe Covid-19 patient was
associated with slightly increased risk of bilateral pneumonia. But
meta-analysis did not reveal any statistical difference (P=0.48).
Consistently, with pooled OR of 0.98 for unilateral pneumonia (95\%CI:
0.40 to 2.42, P=0.97), 3.71 for ground-glass opacities (95\%CI: 0.45 to
30.23, P=0.22), 3.32 for consolidation (95\%CI: 1.00 to 11.03, P=0.05)
and 8.23 for bronchial wall thickening (95\%CI: 0.59 to 115.05, P=0.12),
it was demonstrated that unilateral pneumonia{[}21, 25{]}, ground-glass
opacities {[}15, 21{]}, consolidation{[}15, 21{]} and bronchial wall
thickening {[}15, 21{]} were unrelated to the severity of Covid-19.

However, in 2 trials reporting data on reticulation in CT {[}15, 21{]},
12 of 39 patients in Severe group (30.8\%) and 40 of 145 in Non-severe
group (27.9\%) were found to have reticulation in chest CT. With pooled
OR of 2.86 (95\%CI: 1.01 to 8.14, P\textless{}0.05), it was demonstrated
that patients with reticulation in CT were more likely to progress into
severe Covid-19.

In 2 trials reporting data on intrathoracic lymph node enlargement
{[}15, 21{]}, 8 of 39 patients in Severe group (20.5\%) and 0 of 145 in
Non-severe group (0\%) were found to have intrathoracic lymph node
enlargement. With pooled OR of 31.90 (95\%CI: 3.65 to 278.98, P=0.002)
it was demonstrated that patients with intrathoracic lymph node
enlargement were more likely to progress into severe Covid-19.

In 2 trials reporting data on pleural effusions {[}15, 21{]}, 12 of 39
patients in Severe group (30.8\%) and 9 of 145 in Non-severe group
(6.2\%) were found to have pleural effusions. With pooled OR of 10.84
(95\%CI: 1.07 to 109.80, P=0.04) it was demonstrated that patients with
pleural effusions were more likely to progress into severe Covid-19. The
outcome was explicitly expressed in Table 2.

\textbf{Publication bias}

Publication bias statistics were determined by funnel plot. The plot
demonstrated asymmetry about the pooled effect which publication bias
might exist (Figure 2).

\textbf{Discussion}

Up to now, this is the first meta-analysis to explore severe Covid-19
associated clinical, laboratory and imaging factor when compared with
non-severe Covid-19. By systemically and comprehensively reviewed the
current evidence published, 14 studies with a total of 2,566 individuals
(771 in Severe group and 1,795 in Non-severe group) were eligible for
this meta-analysis{[}14-27{]}, which retrieved the largest sample size
when compared with studies on the same topic. Overlapping patient was
checked by examining the first author of article and the origin of
patients, since we recognized that different articles might report of
the same patients.

Currently, the National Health Commission (NHC) issued the China
Guidelines for the Diagnosis and Treatment Plan of Novel Coronavirus
(COVID-19), which defined the degree of severity of Covid-19 (i.e.,
mild, common, severe and critical). As we all know, treatment algorithm
of Covid-19 depended on illness severity. Most severe and critical
patients required oxygen therapy and a minority of the patients needed
invasive ventilation or even extracorporeal membrane oxygenation.
Moreover, there were some patient who developed worsening respiratory
failure and acute respiratory distress syndrome (ARDS) rapidly that
required intubation{[}36{]}. According to epidemiological investigation,
severe illness occurred in 15.7\% of the Covid-19 patients after
admission to a hospital. As the clinical spectrum of COVID-19 ranges
widely from mild illness to ARDS with a high risk of mortality, there is
an urgent need for research to identify early markers of disease
severity, which is of great value for clinician to diagnosis of the
severity of Covid-19 rapidly and exactly.

Though statistical analysis, it was demonstrated that patients in Severe
Covid-19 group were older and had a greater number of comorbid
conditions (e.g., hypertension, diabetes and heart disease) than
Non-severe group. Compromised respiratory status on admission (e.g.,
COPD) was also associated with severe illness. This suggests that age
and comorbidity may be risk factors for poor outcome. Meanwhile, severe
2019-nCoV infection is more likely to affect males. These data was
consistent with the recent report that showed 2019-nCoV infection is
more likely to affect males {[}37{]}. What's more, our outcome did not
support that smoking was associated with severity of COVID-19 illness.
Consistently, Lippi et al conducted a meta-analysis of current evidence
and concluded that active smoking does not apparently seem to be
significantly associated with enhanced risk of progressing towards
severe disease in Covid-19, which further confirmed our outcome{[}38{]}.

Common symptoms of Covid-19 at onset of illness were fever, dry cough,
expectoration, myalgia, fatigue, and dyspnea {[}1{]}. However, some
patients presented initially with atypical symptoms, such as diarrhea
and nausea {[}39, 40{]}. By statistical synthesis the data on common
sign and symptoms, the incidence of fever, expectoration, headache,
fatigue, myalgia and dyspnea were more common in Severe group than in
Non-severe group. However, only the incidence of dyspnea was
statistically different across groups. Thus, patient presented with
dyspnea should gain more caution for which might be severe Covid-19. And
this outcome was consistent with outcome found in ICU patient{[}41{]}.

Accumulating evidence suggests that a subgroup of patients with severe
COVID-19 might have a cytokine storm syndrome{[}42{]}. In our study,
compared with non-severe patients, severe Covid-19 patients had numerous
laboratory abnormalities. By meta-analysis of current evidence,
depressed total lymphocytes were observed in this article. These
abnormalities suggest that 2019-nCoV infection may be associated with
cellular immune deficiency. And these laboratory abnormalities are
similar to those previously observed in patients with MERS-CoV and
SARS-CoV infection{[}43{]}.

Individuals with severe Covid-19 might present with bilateral (95.8\%)
or unilateral (30.5\%) lung pathological changes, ground-glass opacities
(100\%), consolidation (76.9\%) and bronchial wall thickening (56.4\%)
in chest CT. However, no statistical difference was revealed when
compared with Non-severe group. Although reticulation (30.8\%),
intrathoracic lymph node enlargement (20.5\%) and pleural effusions
(30.8\%) were relatively rarely seen, meta-analysis revealed that
patients with reticulation, intrathoracic lymph node enlargement and
pleural effusions in chest CT were associated with more likelihood to be
a severe Covid-19. The outcome was further confirmed in a study carried
by Yuan eta al which investigated the association of radiologic findings
with mortality of patients infected with Covid-19{[}16{]}.

The results should be viewed with recognition of limitations inherent in
this study. Firstly, although a broad review scope provides us with a
larger sample size and finally adequate statistical power to detect a
risk factor, three articles reporting data comparing clinical
characteristic between severe Covid-19 and non-severe Covid-19 was
excluded for overlapping patients {[}3, 35, 44{]}. One article that did
not reported the origin of patient was also excluded from this
meta-analysis {[}29{]}, which resulted in relative small sample size.
However, their outcome further confirmed our conclusion.

Secondly, all eligible studies came from China, since first Covid-19 was
identified in Wuhan, China. Data in other country was not acceptable
right now. Thus, the outcome of our study could not be considered
conclusive on this topic. An update of this article is necessary when
needed.

Thirdly, more and more articles on Covid-19 were published every day.
There might be lots of article evaluating the clinical difference across
severe and non-severe Covid-19 unpublished. And funnel plot of this
meta-analysis revealed that publication bias might exist. Thus, it is
necessary for clinicians to interpret our outcome carefully.

In conclusion, it was demonstrated that older males manifested with
dyspnea whose blood routine test revealed lymphopenia should gain more
caution for which might be severe Covid-19. Patients with comorbidity,
such as hypertension, diabetes and heart disease were more susceptible
to severe Covid-19. Compromised respiratory status on admission (e.g.,
COPD) was also associated with severe illness. Specially, although
reticulation, intrathoracic lymph node enlargement and pleural effusions
were relatively rarely seen, meta-analysis revealed that patients with
such presentations in chest CT were associated with more likelihood to
be a severe Covid-19.

Although lots of risk factors were filtrated in this article,
exploration of predicted value of these factors in severe Covid-19
patients was impossible with aggregated data extracted from published
studies. Further diagnostic article evaluating how to differentiate
severe from non-severe Covid-19 with the manifestation in chest CT and
study evaluating the relation across clinical characteristic and
severity of Covid-19 with the help of logistic regression analysis is
needed.

\textbf{Author Contributions}

Conceptualization, YJ Zhang and SL Han; methodology, YJ Zhang and SL
Han; software, YJ Zhang and SL Han; validation, XF Sun and B Xie.;
formal analysis, YJ Zhang and SL Han; investigation, YJ Zhang and SL
Han; resources, YJ Zhang and SL Han; data curation, YJ Zhang and SL Han;
writing---original draft preparation, YJ Zhang and SL Han;
writing---review and editing, YJ Zhang and SL Han; visualization, YJ
Zhang and SL Han; supervision, WJ Feng; project administration, YJ Zhang
and SL Han. All authors have read and agreed to the published version of
the manuscript.

\textbf{Conflicts of Interest:}

The intent of this statement is to display our idea on severe Covid-19.
There are no financial and personal relationships with other people or
organizations that could inappropriately influence (bias) our work.

\textbf{Acknowledgements:} None

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Singapore}2020; \textbf{49} : 1-9.

37. Chen N, Zhou M, Dong X et al. Epidemiological and clinical
characteristics of 99 cases of 2019 novel coronavirus pneumonia in
Wuhan, China: a descriptive study. \emph{Lancet} 2020; \textbf{395} :
507-13.

38. G L, BM H. Active smoking is not associated with severity of
coronavirus disease 2019 (COVID-19). \emph{European journal of internal
medicine} 2020.

39. Wu C, Chen X, Cai Y et al. Risk Factors Associated With Acute
Respiratory Distress Syndrome and Death in Patients With Coronavirus
Disease 2019 Pneumonia in Wuhan, China. \emph{JAMA Intern Med} 2020.

40. Zhou Z, Zhao N, Shu Y et al. Effect of gastrointestinal symptoms on
patients infected with COVID-19. \emph{Gastroenterology} 2020.

41. Wang D, Hu B, Hu C et al. Clinical Characteristics of 138
Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in
Wuhan, China. \emph{JAMA} 2020.

42. Mehta P, McAuley DF, Brown M et al. COVID-19: consider cytokine
storm syndromes and immunosuppression. \emph{Lancet} 2020.

43. Lin L, Lu L, Cao W, Li T. Hypothesis for potential pathogenesis of
SARS-CoV-2 infection--a review of immune changes in patients with viral
pneumonia. \emph{Emerg Microbes Infect} 2020: 1-14.

44. Chen G, Wu D, Guo W et al. Clinical and immunologic features in
severe and moderate Coronavirus Disease 2019. \emph{Journal of Clinical
Investigation} 2020.

Table 1. Characteristic of eligible studies.\selectlanguage{english}
\begin{longtable}[]{@{}llllllll@{}}
\toprule
\begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Study ID\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Location\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Hospital\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Date (month, day)\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Study type\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Sample size\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Severe group\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Non-severe group\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Tian et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Beijing, China\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Designated hospitals in Beijing\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 20 to Feb 10\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Multi-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
262\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 46\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common: 216\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Li et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Chongqing, China\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Second Affiliated Hospital of Chongqing Medical University\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan to Feb\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
83\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe/critical: 25\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common: 58\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Qin et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Tongji Hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 10 to Feb 12\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
452\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 286\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Non-severe:166\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Qu et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Huizhou, Guangdong Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Huizhou municipal central hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan to Feb\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
30\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 3\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Non-severe: 27\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Shi et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Zhejiang Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Designated hospitals in Zhejiang Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Up to Feb 17\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Multi-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
487\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe:49\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Mild: 438\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Zhao et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Hunan Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Designated hospitals in Hunan Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
NR\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Multi-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
101\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe/critical: 14\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common/Mild: 87\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Zhang et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
No.7 hospital of Wuhan\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 16 to Feb 3\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
140\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 58\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Non-severe: 82\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Wu et al\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yancheng and Wuxi, Jiangsu province; Fuyang, Anhui Province\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
First People's Hospital of Yancheng; Second People's Hospital of Fuyang;
Second People's Hospital of Yancheng; Fifth People's Hospital of
Wuxi\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Jan 20 to Feb 19\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Muti-center\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
280\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Severe/critical: 83\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Common/Mild: 197\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Zhang et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Xinzhou District People's Hospita\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Up to Mar 2\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
95\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe:32\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Non-severe: 63\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Zheng et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei Province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan Union Hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Up to Feb 15\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
55\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe:21\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common: 34\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wan et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Chongqing, China\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Three Gorges Central Hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 23 to Feb 8\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
135\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe:40\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Mild: 95\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Yuan et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Shenzhen, China\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Shenzhen Third People's Hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 11 to Feb 13\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
94\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 11\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common/Mild: 83\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Han et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Renmin Hospital of Wuhan University\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Jan 1 to Feb 18\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
273\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe/critical: 75\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Mild: 198\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Xie et al\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan, Hubei province\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Wuhan Jinyintan hospital\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Feb 2 to Feb 23\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Single-center\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
79\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Severe: 28\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Common: 51\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Table 2. The pooled outcome for the association between demography
characteristic, comorbidity, signs and symptoms, laboratory test, image
feature in chest CT and severity of Covid-19.\selectlanguage{english}
\begin{longtable}[]{@{}lllllll@{}}
\toprule
\begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
Outcome\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
No. of study\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
Sample size\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
Sample size\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
OR or WMD (95\%CI)\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
Heterogeneity\strut
\end{minipage} & \begin{minipage}[b]{0.14\columnwidth}\raggedright\strut
Difference\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Severe Group\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Non-Severe Group\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Demography characteristic\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
14\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
771\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1795\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
11.12 {[}6.70, 15.55{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001; I\selectlanguage{ngerman}² =92\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.00001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Sex (male, year)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
12\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
409 in 747 (54.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
843 in 1724 (48.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.30 {[}1.07, 1.57{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P= 0.62; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.007\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Comorbidity\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Hypertension\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
166 in 497(33.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
151 in 973(15.5 \%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.30 {[}1.35, 3.92{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.03; I\selectlanguage{ngerman}²= 57\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Diabetes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
88 in 497(17.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
65 in 973(6.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.62 {[}1.27, 5.44{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.02; I\selectlanguage{ngerman}²= 61\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.009\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Heart Disease\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
46 in 497 (9.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
29 in 973 (3.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4.02 {[}2.08, 7.77{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.29; I\selectlanguage{ngerman}² = 18\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Cerebrovascular Disease\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
10 in 344(2.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4 in 248(1.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.81 {[}0.56, 5.84{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.66; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.32\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
COPD\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
5\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
20 in 492(4.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4 in 598(0.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4.20 {[}1.61, 10.95{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.42; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.003\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Chconic live disease\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
13 in 476(2.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
30 in 883(3.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.28 {[}0.60, 2.71{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.45; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.53\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Chronic kidney disease\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
12 in 476(2.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
10 in 883(1.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.12 {[}0.80, 5.61{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.34; I\selectlanguage{ngerman}²= 11\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.13\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Tuberculosis\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
9 in 344(2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2 in 248(0.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.69 {[}0.66, 10.97{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.47; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.17\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Smoke\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
16 in 433(3.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
49 in 781(6.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.07 {[}0.40, 2.85{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.12; I\selectlanguage{ngerman}²= 48\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.90\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Any\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
226 in 398(56.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
137 in 430(31.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3.61 {[}1.62, 8.01{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.003; I\selectlanguage{ngerman}² = 78\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Signs and Symptoms\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Fever\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
9\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
552 in 593(93.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
795 in 957(83.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.93 {[}0.94, 3.96{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.007; I\selectlanguage{ngerman}² = 62\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.07\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Expectoration\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
144 in 379(38.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
94 in 370(25.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.79 {[}0.79, 4.05{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.02; I\selectlanguage{ngerman}²= 69\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.17\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Headache\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
56 in 397(14.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
56 in 525(10.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.43 {[}0.91, 2.26{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.74; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.12\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Fatigue\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
4\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
210 in 396(53.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
189 in 522(36.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.75 {[}0.89, 3.44{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.02; I\selectlanguage{ngerman}² = 69\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.11\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Myalgia\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
114 in 394(28.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
70 in 421(16.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.22 {[}0.65, 7.52{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001; I\selectlanguage{ngerman}² = 90\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.20\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Dyspnea\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
5\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
82 in 192(42.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
52 in 477(10.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7.83 {[}1.75, 34.99{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001; I\selectlanguage{ngerman}²=86\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.007\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Laboratory test(x109 \selectlanguage{english}per L)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Leucocytes count\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
518\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
649\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.65 {[}-1.02, 2.32{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001;I\selectlanguage{ngerman}²=94\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.44\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Neutrophils count\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
483\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
601\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.33 {[}-0.66, 1.33{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001;I\selectlanguage{ngerman}²=94\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.51\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Lymphocyte count\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
539\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
683\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
-0.42 {[}-0.64, -0.20{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.0001; I\selectlanguage{ngerman}² = 92\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.0002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Monocyte count\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
384\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
391\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.01 {[}-0.06, 0.09{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.05; I\selectlanguage{ngerman}² = 66\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.70\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Image feature in chest CT\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Bilateral pneumonia\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
5\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
162 in 219(95.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
378 in 515(73.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.48 {[}0.50, 4.35{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.09; I\selectlanguage{ngerman}² = 53\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.48\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Unilateral pneumonia\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
47 in 154(30.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
99 in 362(27.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.98 {[}0.40, 2.42{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P =0.18; I\selectlanguage{ngerman}² = 42\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.97\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Ground-glass opacities\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
39 in 39(100\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
129 in 145(89.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3.71 {[}0.45, 30.23{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.66; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.22\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Consolidation\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
30 in 39(76.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
67 in 145(46.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
3.32 {[}1.00, 11.03{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.17; I\selectlanguage{ngerman}² = 48\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.05\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Reticulation\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
12 in 39(30.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
40 in 145(27.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2.86 {[}1.01, 8.14{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.34; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P\textless{}0.05\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Bronchial wall thickening\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
22 in 39(56.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
25 in 145(16.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
8.23 {[}0.59, 115.05{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.004; I\selectlanguage{ngerman}² = 88\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.12\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Intrathoracic lymph node enlargement\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
8 in 39(20.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0 in 145(0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
31.90 {[}3.65, 278.98{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.67; I\selectlanguage{ngerman}² = 0\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pleural effusions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
12 in 39(30.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
9 in 145(6.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
10.84 {[}1.07, 109.80{]}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P = 0.13; I\selectlanguage{ngerman}² = 57\%\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
P=0.04\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
OR= odds ratio; WMD=weighted mean difference; 95\%CIs+95\% confidence
intervals; COPD= chronic obstructive pulmonary disease.\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Figure legend

Figure 1. Trials flow of selecting eligible studies.

Figure 2. Funnel plot for publication bias.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/trial-flow/trial-flow}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure2------Fa-Biao-Pian-Yi-/Figure2------Fa-Biao-Pian-Yi-}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

