Worldwide One-Year Dynamics of COVID-19 Manifestations: A Systematic Review and Meta-Analysis

Worldwide One-Year Dynamics of COVID-19 Manifestations: A Systematic Review and Meta-Analysis


  • Samaneh Abiri Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.
  • Aref Ghanaatpisheh Student research committee, Jahrom University of Medical Sciences, Jahrom, Iran.
  • Mojtaba Sohrabpour Assistant Professor of Otorhinolaryngology, Head and Neck Surgery, Fasa University of Medical Science, Fasa, Iran.
  • Mohammad Sadegh Sanie Jahromi Anesthesiology, Critical care and pain management research center, Jahrom University of Medical Sciences, Jahrom, Iran.
  • Seyed Reza Habibzadeh Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
  • Behzad Shahi Department of Emergency Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Mashhad, Iran.
  • Mahdi Foroughian Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
  • Fatemeh Maleki Department of Emergency Medicine, Faculty of Medicine, Birjand University of Medical sciences, Birjand, Iran.
  • Arman Hakemi Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.
  • Esmaeil Rayat Dost Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.
  • Ali Kazeminezhad Department of Neurosurgery, Peymanieh Hospital, Jahrom University of Medical Sciences, Jahrom, Iran.


COVID-19, Fever, Symptom, Meta-Analysis


Objective: To evaluate if the pattern of COVID-19 symptoms prevalence changes over time or not.
Study design: Systematic review and meta-analysis based on the PRISMA statement (PROSPERO registration code: CRD42021296324).
Method: To assess the pooled prevalence of COVID-19 symptoms in various time intervals, COVID-19 cross-sectional studies published in databases of MEDLINE, EMBASE, PubMed, Scopus, Science Direct, Embase, Cochrane, and Web of Science were queried with proper keywords. Sample size, prevalence of clinical signs, country and months of conducting study were extracted and quantitively evaluated in Comprehensive Meta-Analysis software.
Results: In this systematic review and meta-analysis, 57 studies were included. pooled prevalence of fever varied from 85.8% in first months of the COVID-19 pandemic to 34.2% in last months reported in literature. In case of the pooled prevalence of cough in January-February, it was estimated to be 83.4; while in later conducted studies it was significantly lower, about the 55.3%. Myalgia prevalence rate ranged from 53.2% in first months to 2.5% later. Headache rate varied from 61.4% to 17.6% passing the time of studies. Dyspnea rate ranged from 49.4% to 5.2% throughout time.
Conclusion: While due to the possible effect of study region and sample differences on the prevalence of each symptom; our study showed a significant changing pattern of COVID-19 main symptoms over time.



We appreciate the Clinical Research Development Unit of Peymanieh Educational and Research and Therapeutic Center of Jahrom University of Medical Sciences for providing facilities for this work.

Research funding: None.

Author contributions: SA, AG, and AK conceptualized the study topic.  MS, MSSJ, SRH, BS performed the initial literature review.  MF, FM, AH, and ER performed the data extraction. AK SA, and AG conducted the data analysis. the manuscript was written by MS, MSSJ, and SRH. all authors contributed to revisions.

Competing interests: None. 

 Ethical approval: NA.

UiEM promotes transparency in Peer-Review to achieve high-quality science. Comments of reviewers are provided in the metadata of the article.


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How to Cite

Abiri, S., Ghanaatpisheh, A., Sohrabpour, M., Sanie Jahromi, M. S., Habibzadeh, S. R., Shahi, B., Foroughian, M., Maleki, F., Hakemi, A., Rayat Dost, E., & Kazeminezhad, A. (2022). Worldwide One-Year Dynamics of COVID-19 Manifestations: A Systematic Review and Meta-Analysis. Updates in Emergency Medicine, 2(1), 23–33. Retrieved from



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