Systematic Reviews
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2021; 9(1): 118-132
Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.118
Comparative profile for COVID-19 cases from China and North America: Clinical symptoms, comorbidities and disease biomarkers
Alaa Badawi, Denitsa Vasileva
Alaa Badawi, Public Health Risk Sciences Division, Public Health Agency of Canada, Toronto M5V3L7, ON, Canada
Alaa Badawi, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto M5S1A8, ON, Canada
Denitsa Vasileva, Center for Heart Lung Innovation, University of British Columbia, Vancouver V6Z1Y6, BC, Canada
Author contributions: Badawi A conceived the study idea and design, data acquisition, analysis and interpretation and wrote the manuscript; Vasileva D assisted in the screening and selection of the evaluated studies; both authors critically reviewed the manuscript, approved the final draft and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alaa Badawi, PhD, Professor, Senior Researcher, Public Health Risk Sciences Division, Public Health Agency of Canada, 180 Queen Street West, Toronto M5V3L7, ON, Canada. alaa.badawi@canada.ca
Received: September 15, 2020
Peer-review started: September 15, 2020
First decision: October 18, 2020
Revised: November 2, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: January 6, 2021
Processing time: 107 Days and 21.7 Hours
ARTICLE HIGHLIGHTS
Research background

Large inter-individual and inter-population differences in the susceptibility to and outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) have been noted. Understanding these differences and how they influence vulnerability to infection and disease severity is critical to public health intervention.

Research motivation

To evaluates the inter-population differences in the SARS-CoV-2 or COVID-19 between China and North America.

Research objectives

The objective of this systematic review and meta-analysis is to analyze and compare the profile of COVID-19 cases between China and North America as two regions that differ in many environmental, host and healthcare factors related to disease risk.

Research methods

We conducted a meta-analysis to examine and compare demographic information, clinical symptoms, comorbidities, disease severity and levels of disease biomarkers of COVID-19 cases from clinical studies and data from China (105 studies) and North America (19 studies).

Research results

Fever, cough, fatigue and dyspnea were the most common clinical symptoms of COVID-19 in both study regions. Hypertension, diabetes and cancer were the most prevalent comorbidities in COVID-19 cases from China whereas obesity, hypertension and diabetes were the most prevalent in North America. Prevalence of comorbidities in COVID-19 cases increased with age but was at younger ages in cases from China compared to those from North America. Inflammatory markers such as C-reactive protein were 4.5-fold higher in the North American cases than in cases from China.

Research conclusions

The differences in COVID-19 profile between China and North America reflects the differences in environmental-, host- and healthcare-related factors between the two regions.

Research perspectives

Inter-population differences – together with intra-population variability – underline the need to characterize the effect of health inequities and inequalities on public health response to COVID-19 and can assist in preparing for the re-emergence of the epidemic.