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

Abstract

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.

SARS-CoV-2 triggered excessive inflammation and abnormal energy metabolism in gut microbiota

“…The clot waveform of APTT also suggested that COVID-19 patients might have distinctive abnormal coagulopathy [27]. High-level total bilirubin is generally considered a marker of abnormal liver metabolism and hepatitis, and there appears to be a significant relationship between hemoglobin levels and COVID-19 disease severity [28]. According to the mentioned results, the recruited COVID-19 patients might have liver damage, pathogen infection and blood system disorders.…”

“…No reuse allowed without permission. severity [28]. According to the mentioned results, the recruited COVID-19 patients might have liver damage, pathogen infection and blood system disorders.…”

The Role of CRP, Interleukin-6 and Their Derived Immune-Inflammatory Indices in Early Prediction of Severity and Mortality of COVID-19 Patients

“…[21&22]. Several have studies emphasized that when the lymphocyte count is less than 1.5 10 3 /µL, lymphopenia should be addressed [9].…”

“…21 , 22 Several studies have emphasized that when the lymphocyte count is less than 1.5 10 3 /µL, lymphopenia should be addressed. 9 Using an inflammatory biomarker alone to evaluate patients infected with COVID-19 could be influenced by several factors. As a result, the generated indices from the most important inflammatory biomarkers may more accurately and thoroughly indicate immunological dysregulation.…”

Associations and prognostic accuracy of electrolyte imbalances in predicting poor COVID-19 outcome: a systematic review and meta-analysis

“…[62][63][64] This was observed in our results where hyponatremia, hypocalcemia and hypokalmia were significantly associated with higher baseline CRP levels, which itself is an established marker for inflammation and a more severe disease course. [65] Electrolyte imbalances may also be a general indication of kidney involvement where AKI has been reported to be prevalent in patients hospitalized with COVID-19. [66] However, in a number of the included primary studies, the association of some electrolyte imbalances with poorer outcome in COVID-19 remained significant even after adjusting for inflammatory biomarkers.…”