Objective To describe the laboratory parameters and biomarkers of the cytokine storm syndrome associated with severe and fatal COVID-19 cases. Methods A search with standardized descriptors and synonyms was performed on November 28th, 2020 of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, LILACS, and IBECS to identify studies of interest. Grey literature searches and snowballing techniques were additionally utilized to identify yet-unpublished works and related citations. Two review authors independently screened the retrieved titles and abstracts, selected eligible studies for inclusion, extracted data from the included studies, and then assessed the risk of bias using the Newcastle-Ottawa Scale. Eligible studies were those including laboratory parameters—including serum interleukin-6 levels—from mild, moderate, or severe COVID-19 cases. Laboratory parameters, such as interleukin-6, ferritin, hematology, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer, were extracted from the studies. Meta-analyses were conducted using the laboratory data to estimate mean differences with associated 95% confidence intervals. Data synthesis The database search yielded 9,620 records; 40 studies (containing a total of 9,542 patients) were included in the final analysis. Twenty-one studies (n = 4,313) assessed laboratory data related to severe COVID-19 cases, eighteen studies (n = 4,681) assessed predictors for fatal COVID-19 cases and one study (n = 548) assessed laboratory biomarkers related to severe and fatal COVID-19 cases. Lymphopenia, thrombocytopenia, and elevated levels of interleukin-6, ferritin, D-dimer, aspartate aminotransferase, C-Reactive-Protein, procalcitonin, creatinine, neutrophils and leucocytes were associated with severe and fatal COVID-19 cases. Conclusions This review points to interleukin-6, ferritin, leukocytes, neutrophils, lymphocytes, platelets, C-Reactive Protein, procalcitonin, lactate dehydrogenase, aspartate aminotransferase, creatinine, and D-dimer as important biomarkers of cytokine storm syndrome. Elevated levels of interleukin-6 and hyperferritinemia should be considered as red flags of systemic inflammation and poor prognosis in COVID-19.

Since the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged, the coronavirus disease (COVID-19) has spread worldwide. On March 11, 2020, the World Health Organization declared the outbreak of the COVID-19 disease to be a pandemic event and a Public Health Emergency of International Concern. In the meantime, its epidemiological picture has been constantly changing. Up to July 9, 2020, almost 12 million cases had been confirmed, with 545,481 deaths, in 213 countries and territories around the world, as reported to the World Health Organization (WHO). 1,2 Amidst this pandemic, the world still needs to deal with the burden of various other diseases that present overlapping occurrences. Whether these are communicable or non-communicable, much remains to be learned regarding how to manage them all, so as to simultaneously mitigate issues relating to healthcare system saturation. In particular, countries located in tropical and subtropical regions, where arboviral diseases occur abundantly, are still dealing with these old endemics, which for some countries are epidemic diseases. 3-6 Individuals affected by these various diseases may present clinical features that range from subclinical to severe forms, such as encephalitic or hemorrhagic forms, with very significant fatality rates. 5 It has been estimated that more than two billion people live in environments suitable for arbovirus dissemination. 7 Throughout the world, epidemiologists have been warning of temporal coincidence between endemic peaks and outbreaks relating to arboviruses and COVID-19. 8,9 The constantly evolving knowledge of COVID-19 and its characteristics suggests that it and arboviral diseases share similarities with regard to clinical manifestations and laboratory findings. 4,7 So far, dengue fever

CONTEXT AND OBJECTIVE: The current health crisis due to COVID-19 is forcing us to profoundly rethink our social organizations and practices in health. While there is no effective treatment for the virus, staying home and social isolation are the control measures recommended by health authorities. The aim of this study is to perform a scoping review in order to summarize the current evidence in telehealth for COVID-19. METHODS: This study is a protocol to describe the rationale, hypothesis and planned methods of our scoping review. We will include randomized controlled trials (RCTs), observational cohort studies, case-control studies, cross-sectional studies, qualitative studies, and/or case series that describe telehealth interventions applied or developed to respond to COVID-19. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, and Scopus. We will include studies performed since December 2019 with no language restrictions. We will use the Risk of Bias tool and the Newcastle-Ottawa Scale to perform the critical appraisal of included studies. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

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