Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review

Vakili, Sina; Savardashtaki, Amir; Jamalnia, Sheida; Tabrizi, Reza; Nematollahi, Mohammad Hadi; Jafarinia, Morteza; Akbari, Hamed

doi:10.1016/j.arcmed.2020.06.007

Cited by 87 publications

(69 citation statements)

References 27 publications

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“…Randomized and cohort studies with information of the days from the onset of their symptoms to the first test day are recommended to provide more accurate results. Third, the laboratory findings of COVID-19 infection are approved to be conflicting in different age groups [18], so the results of the present study should be interpreted with caution as the average age of non-survivors significantly differed from the survivors. Despite these limitations, this study presented the temporal changes in systematic laboratory test results of patients with COVID-19, deepening the understanding of this disease and providing actionable laboratory markers to identify high-risk patients.…”

Section: Discussionmentioning

confidence: 77%

Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19

et al. 2020

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Background Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, and outbreaks have occurred worldwide. Laboratory test results are an important basis for clinicians to determine patient condition and formulate treatment plans. Methods Fifty-two thousand six hundred forty-four laboratory test results with continuous values of adult inpatients who were diagnosed with COVID-19 and hospitalized in the Fifth Hospital in Wuhan between 16 January 2020 and 18 March 2020 were compiled. The first and last test results were compared between survivors and non-survivors with variance test or Welch test. Laboratory test variables with significant differences were then included in the temporal change analysis. Results Among 94 laboratory test variables in 82 survivors and 25 non-survivors with COVID-19, white blood cell count, neutrophil count/percentage, mean platelet volume, platelet distribution width, platelet-large cell percentage, hypersensitive C-reactive protein, procalcitonin, D-dimer, fibrin (ogen) degradation product, middle fluorescent reticulocyte percentage, immature reticulocyte fraction, lactate dehydrogenase were significantly increased (P < 0.05), and lymphocyte count/percentage, monocyte percentage, eosinophil percentage, prothrombin activity, low fluorescent reticulocyte percentage, plasma carbon dioxide, total calcium, prealbumin, total protein, albumin, albumin-globulin ratio, cholinesterase, total cholesterol, nonhigh-density/low-density/small-dense-low-density lipoprotein cholesterol were significantly decreased in non-survivors compared with survivors (P < 0.05), in both first and last tests. Prothrombin time, prothrombin international normalized ratio, nucleated red blood cell count/percentage, high fluorescent reticulocyte percentage, plasma uric acid, plasma urea nitrogen, cystatin C, sodium, phosphorus, magnesium, myoglobin, creatine kinase (isoenzymes), aspartate aminotransferase, alkaline phosphatase, glucose, triglyceride were significantly increased (P < 0.05), and eosinophil count, basophil percentage, platelet count, thrombocytocrit, antithrombin III, red blood cell count, haemoglobin, haematocrit, total carbon dioxide, acidity-basicity, actual bicarbonate radical, base excess in the extracellular fluid compartment, estimated glomerular filtration rate, high-density lipoprotein cholesterol, apolipoprotein A1/ B were significantly decreased in non-survivors compared with survivors (P < 0.05), only in the last tests. Temporal changes in 26 variables, such as lymphocyte count/percentage, neutrophil count/percentage, and platelet count, were obviously different between survivors and non-survivors. Conclusions By the comprehensive usage of the laboratory markers with different temporal changes, patients with a high risk of COVID-19-associated death or progression from mild to severe disease might be identified, allowing for timely targeted treatment.

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Section: Discussionmentioning

confidence: 77%

Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19

et al. 2020

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“…The most common symptom in infants is associated with the respiratory tract, suggesting that the respiratory tract of this age group is not sufficiently developed and it can easily become symptomatic with inflammation in this area. Different age groups often also have different susceptibility to COVID-19 infection [48,49]. It is well known that people aged >70 years have higher mortality than younger people [50,51].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of confirmed COVID-19 in newborns: a systematic review

Karabay

Çınar

Suzan

et al. 2020

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: Aim of this systematic review is to investigate the available evidence describing neonatal outcomes in newborns who have SARS-CoV-2 infection in order to guide prevention of COVID-19 in newborns. Methods: This is the study protocol for a systematic review. MEDLINE, Web of Science, PubMed, Science Direct, CINAHL, Scopus, Cochrane, TUB _ ITAK databases, and key words of "Newborn" (neonatal OR clinical characteristics newborn OR infants less than 1 month OR infants less than 28 weeks OR Neonate) AND "clinical presentation" (epidemiology OR symptoms OR clinical course OR features) AND "COVID-19" (Coronavirus OR COVID-19 OR Sars-Cov2 OR coronavirus disease 2019 OR Novel Coronavirus OR 2019-nCoV) were searched for this systematic review. Randomized controlled trial, cross-sectional, case-control, and case reports, case reports examining neonatal outcomes in newborns who have SARS-CoV-2 infection were included. Studies were selected according to criteria around the population, intervention, comparator, outcome(s) of interest, and study design (PICOS framework). All citations and full-text articles were searched by independent five authors. The population that newborns with COVID-19 that confirmed within 28 d of birth are included. The interventions included in COVID-19 infection diagnosed via reverse transcription-polymerase chain reaction (RT-PCR) or serological. The primary outcomes were Neonatal clinical outcomes. The methodological quality of the studies was appraised using appropriate tools. Strength of the body of evidence was assessed according to the quality assessment tool for quantitative studies (QATQS). Results: The electronic search identified 1051 records that were examined, after evaluating 35 of them were included in the study. Seven studies were research articles and twenty-eight were case reports. Methodological quality was medium. Most of the clinical characteristics of newborns were respiratory difficulty and secondly fever. Some newborns gastrointestinal (GIS) symptoms in the form of diarrhea and feeding intolerance and abdominal distension were present in 50%. The fatality case did not exist in any newborn due to COVID-19. Death occurred in one case due to prematurity. Conclusıons: The most common symptoms in patients with COVID-19 infection in the neonatal period are respiratory tract symptoms and fever. It has been observed that the COVID-19 infection detected in the neonatal period is not fatal. However, data including more cases are needed.

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“…Apart from the clinical symptoms and pulmonary computed tomography (CT) findings, a large number of COVID-19 confirmed patients showed laboratory fluctuations including complete blood count (CBC) variables, cardiac and coagulation parameters, renal and liver function tests, and inflammation-related factors [7,8].…”

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confidence: 99%

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

et al. 2020

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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.

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Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review

Cited by 87 publications

References 27 publications

Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19

Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19

Clinical characteristics of confirmed COVID-19 in newborns: a systematic review

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

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