Clinical Presentation and Outcomes of Hospitalized Adults with COVID-19: A systematic review

AIMS: The aims of this review were to 1) determine the clinical presentation and 2) 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 data 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.