Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: a systematic review and meta-analysis

Abstract

Background: More severe cases of COVID-19 are more likely to be hospitalized and around one-fifth, needing ICU admission. Understanding the common laboratory features of COVID-19 in more severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. This systematic review and meta-analysis aimed to compare the laboratory test findings in severe vs. non-severe confirmed infected cases of COVID-19. Methods: Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of Science, and Google Scholar from the beginning of 2019 to 3rd of March 2020. Heterogeneity across included studies was determined using Cochrane's Q test and the I 2 statistic. We used the fixed or random-effect models to pool the weighted mean differences (WMDs) or standardized mean differences and 95% confidence intervals (CIs). Findings: Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapore) with 3396 ranging from 12 to1099 patients were included. Our meta-analyses showed a significant decrease in lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein ratio (LCR), leukocyte to C-reactive protein ratio (LeCR), leukocyte to IL-6 ratio (LeIR), and an increase in the neutrophil, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen, prothrombin time (PT), D-dimer, glucose level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. No significant changes in white blood cells (WBC), Creatine Kinase (CK), troponin I, myoglobin, IL-6 and K between the two groups were observed. Interpretation: This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 based on laboratory test results at the time of ICU admission. Future well-methodologically designed studies from other populations are strongly recommended.

Characteristics and outcomes of hospitalized adults with COVID-19 in Nepal: a multicenter, prospective cohort study

“…Studies from India and China did not find significant differences in platelet count in relation to symptom status [20,26,28]. Our finding is in contrast to the overall trend of decreasing platelet count with increasing disease severity, found in the studies from the US, China and Korea [31][32][33][34]. One study from Turkey showed that the platelet count was significantly low in COVID-19 PCR positive cases compared to PCR negative cases [35].…”

Hypoalbuminemia in Severe COVID-19 Post Recovery Patients

“…In addition, there was neither correlation between CRP and albumin (-0.3277) nor between ESR and albumin (-0.0504) ( Table 1). Studies have revealed no/slight increase of ESR and CRP 36,38,39 while other studies showed inconsiderable decrease of serum albumin in mildmoderate COVID-19 patients 38,40 . Most importantly no studies conducted on post recovery patients addressing those markers.…”

International register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV SARS-CoV-2): analysis of 1,000 patients

“…При анализе связи лабораторных параметров со смертностью пациентов регистра АКТИВ было найдено, что у умерших пациентов был более высокий уровень СРБ и более низкое содержание лимфоцитов, что соответствует результатам других исследований [22][23][24][25].…”