A meta-analysis of potential biomarkers associated with severity of coronavirus disease 2019 (COVID-19)

Danwang, Célestin; Endomba, Francky Teddy; Nkeck, Jan René; Wouna, Dominic Leandry Angong; Robert, Annie; Noubiap, Jean Jacques

doi:10.1186/s40364-020-00217-0

Cited by 147 publications

(154 citation statements)

References 99 publications

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“…ISARIC‐4C includes blood urea nitrogen and CRP, whereas COVID‐GRAM include lactate dehydrogenase (LDH) and direct bilirubin. CRP and LDH were already described to be associated to advanced pulmonary disease in COVID‐19, 25,26 as well as kidney damage and increased blood urea nitrogen, 27 as confirmed in our study. Conversely, we cannot confirm the usefulness of bilirubin evaluation since the hepatic involvement in our cohort was limited.…”

Section: Discussionsupporting

confidence: 89%

Predicting In‐Hospital Mortality in COVID‐19 Older Patients with Specifically Developed Scores

Covino

Matteis

Burzo

et al. 2020

J American Geriatrics Society

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Background/Objectives Several scoring systems have been specifically developed for risk stratification in COVID‐19 patients. Design We compared, in a cohort of confirmed COVID‐19 older patients, three specifically developed scores with a previously established early warning score. Main endpoint was all causes in‐hospital death. Setting This is a single‐center, retrospective observational study, conducted in the Emergency Department (ED) of an urban teaching hospital, referral center for COVID‐19. Participants We reviewed the clinical records of the confirmed COVID‐19 patients aged 60 years or more consecutively admitted to our ED over a 6‐week period (March 1st to April 15th, 2020). A total of 210 patients, aged between 60 and 98 years were included in the study cohort. Measurements International Severe Acute Respiratory Infection Consortium Clinical Characterization Protocol‐Coronavirus Clinical Characterization Consortium (ISARIC‐4C) score, COVID‐GRAM Critical Illness Risk Score (COVID‐GRAM), quick COVID‐19 Severity Index (qCSI), National Early Warning Score (NEWS). Results Median age was 74 (67–82) and 133 (63.3%) were males. Globally, 42 patients (20.0%) deceased. All the score evaluated showed a fairly good predictive value with respect to in‐hospital death. The ISARIC‐4C score had the highest area under ROC curve (AUROC) 0.799 (0.738–0.851), followed by the COVID‐GRAM 0.785 (0.723–0.838), NEWS 0.764 (0.700–0.819), and qCSI 0.749 (0.685–0.806). However, these differences were not statistical significant. Conclusion Among the evaluated scores, the ISARIC‐4C and the COVID‐GRAM, calculated at ED admission, had the best performance, although the qCSI had similar efficacy by evaluating only three items. However, the NEWS, already widely validated in clinical practice, had a similar performance and could be appropriate for older patients with COVID‐19.

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Section: Discussionsupporting

confidence: 89%

Predicting In‐Hospital Mortality in COVID‐19 Older Patients with Specifically Developed Scores

Covino

Matteis

Burzo

et al. 2020

J American Geriatrics Society

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“…In an article by Yafei Zhang, results showed that there was no significant difference between the CRP levels after transferring the patients to ICU [ 36 ]. Although an increase in CRP level was seen in people with COVID-19 according to some study reports, based on statistical analysis, it was declared that this index may not be a good indicator of the expression of COVID-19 [ 45 ] However, a meta-analysis reported CRP level increased in severe form of COVID-19 [ 63 ]. Furthermore, In our study, based on our analysis, we found that non-survival individuals had higher CRP levels than survival people.…”

Section: Discussionmentioning

confidence: 99%

The laboratory findings and different COVID-19 severities: a systematic review and meta-analysis

Kazemi

Nejat

Ashkan

et al. 2021

Ann Clin Microbiol Antimicrob

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Background Abnormal laboratory findings are common in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this systematic review was to investigate the effect of the level of some laboratory factors (C-reactive protein (CRP), creatinine, leukocyte count, hemoglobin, and platelet count) on the severity and outcome of coronavirus disease 2019 (COVID-19). Methods We searched PubMed, Web of Science, Scopus, and Google Scholar. We collected the articles published before May 26, 2020. We gathered the laboratory factors in groups of patients with COVID-19, and studied the relation between level of these factors with severity and outcome of the disease. Results Mean CRP level, creatinine, hemoglobin, and the leukocytes count in the critically ill patients were significantly higher than those of the other groups (non-critical patients); mean CRP = 54.81 mg/l, mean creatinine = 86.82 μmol/l, mean hemoglobin = 144.05 g/l, and mean leukocyte count = 7.41 × 109. The lymphocyte count was higher in patients with mild/moderate disease (mean: 1.32 × 109) and in the invasive ventilation group (mean value of 0.72 × 109), but it was considerably lower than those of the other two groups. The results showed that the platelet count was higher in critically ill patients (mean value of 205.96 × 109). However, the amount was lower in the invasive ventilation group compared with the other groups (mean level = 185.67 × 109). Conclusion With increasing disease severity, the leukocyte count and the level of CRP increase significantly and the lymphocyte count decreases. There seems to be a significant relation between platelet level, hemoglobin, and creatinine level with severity of the disease. However, more studies are required to confirm this.

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“…As described by Balogun et al [ 7 ], these factors could explain a prolonged hospital stay for DVT patients and give reasons to investigate sepsis, cancer and bedrest as competing risk factors when no complications were noticed in non-DVT patients. Thirdly, inflammatory syndrome, acting as a classical indicator of COVID-19 severity [ 8 ], can slightly worsen a prothrombotic state. Therefore, we hypothesized that in addition to known competing factors such as advanced age, unfavourable NIHSS scores, and medical complications leading to a long hospital stay, a stronger inflammatory syndrome in non-severe COVID-19 can slightly worsen a prothrombotic state that favours DVT.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Deep Venous Thrombosis in Non-Severe COVID-19 Patients Hospitalized for a Neurovascular Disease

Rouyer

Pierre-Paul

Balde

et al. 2020

Cerebrovasc Dis Extra

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Introduction: Severe SARS-CoV-2 infection induces COVID-19 along with venous thromboembolic occurrences particularly in intensive care units. For non-severe COVID-19 patients affected by neurovascular diseases, the prevalence of deep venous thrombosis (DVT) is unknown. The aim of our study was to report data obtained after systematic Doppler ultrasound scanning (DUS) of lower limbs in such patients. Methods: Between March 20 and May 2, 2020, the deep venous system of 13 consecutive patients diagnosed with neurovascular diseases and non-severe COVID-19 was investigated with a systematic bedside DUS. Results: Thirteen patients were enrolled in the study including 9 acute ischaemic strokes, 1 occlusion of the ophthalmic artery, 1 transient ischaemic attack, 1 cerebral venous thrombosis and 1 haemorrhagic stroke. On admission, the median National Institute of Health Stroke Scale (NIHSS) score was of 6 (IQR, 0–20). During the first week after admission, and despite thromboprophylaxis, we found a prevalence of 38.5% of asymptomatic calves’ DVT (n = 5). One patient developed a symptomatic pulmonary embolism and 2 other patients died during hospitalization. The outcome was positive for the other patients with a discharge median NIHSS score of 1 (IQR, 0–11). Discussion/Conclusion: Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence (38.5%) of asymptomatic DVT in non-severe COVID-19 patients suffering from a neurovascular disease. In the absence of a reliable marker of DVT, we suggest that this non-invasive investigation could be an interesting tool to monitor peripheral venous thrombotic complications in such patients.

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A meta-analysis of potential biomarkers associated with severity of coronavirus disease 2019 (COVID-19)

Cited by 147 publications

References 99 publications

Predicting In‐Hospital Mortality in COVID‐19 Older Patients with Specifically Developed Scores

Predicting In‐Hospital Mortality in COVID‐19 Older Patients with Specifically Developed Scores

The laboratory findings and different COVID-19 severities: a systematic review and meta-analysis

High Prevalence of Deep Venous Thrombosis in Non-Severe COVID-19 Patients Hospitalized for a Neurovascular Disease

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