The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased Creactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.

The serological testing of anti‐SARS‐CoV‐2 immunoglobulin G (IgG) and/or IgM is widely used in the diagnosis of COVID‐19. However, its diagnostic efficacy remains unclear. In this study, we searched for diagnostic studies from the Web of Science, PubMed, Embase, CNKI, and Wanfang databases to calculate the pooled diagnostic accuracy measures using bivariate random‐effects model meta‐analysis. As a result, 22 from a total of 1613 articles, including 2282 patients with SARS‐CoV‐2 and 1485 healthy persons or patients without SARS‐CoV‐2, were selected for a meta‐analysis. Pooled sensitivity, specificity, and area under curve of the summary receiver operator curve (SROC) were: (a) 0.85 (95% confidence interval [CI]: 0.79‐0.90), 0.99 (95% CI: 0.98‐1.00), and 0.99 (95% CI: 0.97‐0.99) for anti‐SARS‐CoV‐2 IgG and (b) 0.74 (95% CI: 0.65‐0.81), 0.99 (95% CI: 0.97‐1.00), and 0.95 (95% CI: 0.93‐0.97) for IgM. A subgroup analysis among detection methods indicated the sensitivity of IgG and IgM using enzyme‐linked immunosorbent assay were slightly lower than those using gold immunochromatography assay (GICA) and chemiluminescence immunoassay ( P > .05). These results showed that the detection of anti‐SARS‐CoV‐2 IgG and IgM had high diagnostic efficiency to assist the diagnosis of SARS‐CoV‐2 infection. And, GICA might be used as the preferred method for its accuracy and simplicity.

Purpose: To investigate the levels of human telomerase reverse transcriptase (hTERT) DNA in the plasma of patients with hepatocellular carcinoma (HCC), and to evaluate the diagnostic value and correlation of hTERT DNA with clinical parameters in HCC. Methods: A real-time quantitative fluorescent polymerase chain reaction (FQ-PCR) system was designed and evaluated. Plasma samples were collected from 60 HCC patients, 21 patients with hepatitis B virus (HBV) and 29 healthy controls. Plasma DNA was extracted and quantified by FQ-PCR. The diagnostic value of plasma hTERT DNA levels and their relationships with clinical characteristics were analyzed statistically. Results: Plasma levels of hTERT DNA in HCC patients were significantly higher than in HBV patients (4.18×104±4.94×104 copies/μl vs 1.21×104±6.63×103 copies/μl, P=0.003) and healthy controls (4.18×104±4.94×104 copies/μl vs 1.44×104±6.61×103 copies/μl, P < 0.001). Receiver operating characteristic curve analysis indicated a sensitivity of 64% and a specificity of 90% for the ability of hTERT DNA levels to detect malignancy at a cutoff value of 1.87×104 copies/μl. Association analysis revealed that plasma hTERT DNA levels were closely related to tumor size, portal vein cancer embolus and TNM stage (P=0.013, P=0.010, and P=0.029, respectively), but were not associated with lymph node metastasis, hepatitis B surface antigen, or α-fetoprotein (AFP) (all P > 0.05). The levels of plasma hTERT DNA in HCC patients with AFP ≤20 ng/ml were significantly higher than in HBV patients (4.59×104±4.98×104 copies/μl vs 1.44×104±6.63×103 copies/μl, P=0.016) and in healthy controls (4.59×104±4.98×104 copies/μl vs 1.21×104±6.63×103 copies/μl, P=0.001). Conclusions: Quantitation of plasma hTERT DNA by FQ-PCR may provide a novel complementary tool with potential clinical applications for the screening and detection of HCC. Plasma hTERT DNA has the potential to be a broad tumor marker for common cancers.

No abstract

BackgroundIGF‐binding protein 3（IGFBP‐3）has previously been identified as tumor marker. The present study aimed to investigate the clinical significance of serum IGFBP‐3 in colorectal cancer (CRC).MethodsSerum was collected from 70 CRC patients and 50 healthy volunteer controls. Serum IGFBP‐3 and carcinoembryonic antigen (CEA) levels were measured using electrogenerated chemiluminescence immunoassay and compared between groups. Relationships between serum IGFBP‐3 level and the clinical characteristics of CRC were also analyzed. A receiver operator characteristic (ROC) curve was plotted to investigate diagnostic efficacy of serum IGFBP‐3 and CEA, respectively, for CRC. Data were analyzed using SPSS 13.0.ResultsSerum IGFBP‐3 levels in CRC were lower than those of controls (4.68 [3.56, 5.77] vs 5.44 [4.77, 6.10] µg/mL, P < 0.05). Furthermore, serum IGFBP‐3 levels were higher in early cancer stages (I and II) than those of advanced stages (III and IV) (4.78 [3.92, 5.49] vs 3.77 [2.65, 4.59] µg/mL, P < 0.05). In addition, patients with lymph node metastasis absent had elevated serum IGFBP‐3 levels than those of patients with lymph node metastasis present (4.73 [3.92, 5.72] vs 4.11 [2.45, 4.83] µg/mL, P = 0.02). Finally, ROC curve indicated that serum IGFBP‐3 had a better diagnostic power for CRC than CEA. When serum IGFBP‐3 and carcinoembryonic antigen were used together to detect CRC, the AUC was 0.949, with a sensitivity of 75% and a specificity of 90%.ConclusionsSerum IGFBP‐3 might be a potential biomarker for CRC.