Utility of Routine Laboratory Biomarkers to Detect COVID-19: A Systematic Review and Meta-Analysis

Abstract

No routine laboratory biomarkers perform well enough in diagnosing COVID-19 in isolation for them to be used as a standalone diagnostic test or to help clinicians prioritize patients for treatment. Instead, other diagnostic tests are needed. The aim of this work was to statistically summarise routine laboratory biomarker measurements in COVID-19-positive and -negative patients to inform future work. A systematic literature review and meta-analysis were performed. The search included names of commonly used, routine laboratory tests in the UK NHS, and focused on research papers reporting laboratory results of patients diagnosed with COVID-19. A random effects meta-analysis of the standardized mean difference between COVID-19-positive and -negative groups was conducted for each biomarker. When comparing reported laboratory biomarker results, we identified decreased white blood cell, neutrophil, lymphocyte, eosinophil, and platelet counts; while lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase were elevated in COVID-19-positive compared to COVID-19-negative patients. Differences were identified across a number of routine laboratory biomarkers between COVID-19-positive and -negative patients. Further research is required to identify whether routine laboratory biomarkers can be used in the development of a clinical scoring system to aid with triage of patients.

COVID19 biomarkers: What did we learn from systematic reviews?

“…↑ (Alnor et al, 2020;Chua et al, 2021;Liu et al, 2021a;Lim et al, 2021;Suklan et al, 2021;Melo et al, 2021;Cao et al, 2022) Lymphocytes count…”

Possible Role of P-selectin Adhesion in Long-COVID: A Comparative Analysis of a Long-COVID Case Versus an Asymptomatic Post-COVID Case

“…Commonly reported for COVID-19 positive patients are lymphocytopenia, as well as elevated levels of D-dimer, lactate dehydrogenase, ferritin, Von Willebrand factor, Factor VIII, and inflammatory markers like C-reactive protein, IL-6 and erythrocyte sedimentation rate [9][10][11][12]. Despite seeming trends, the reports do not present consistent picture of COVID-19-associated changes and can be hard to reconcile with existing patient-to-patient variability as the reportedly altered values in many cases remain within the normal physiological range.…”

Routine Laboratory Testing Role For Covid-19 Identification: A Systematic Review

“…Higher NLR is correlated with increase severity of COVID-19 and might be due to viral load and immune response provoked. 14,20,23 Inflammatory markers such as Creactive protein (CRP) that is found high in COVID-19 cases might be useful to differentiate the diagnosis with other form of viral pneumonias although unlikely able to differentiate the condition from bacterial pneumonias. High level of C-reactive protein in COVID-19 is due to cytokine storm that is known to occur in pathogenesis of the disease and is linked to higher severity and rates of mortality.…”

“…Biomarker that is readily accessible, specially at public health center, has an advantage of faster result times and could serve as guide to isolate the patient and even some has potential as prognostic marker therefore likely severe patient could be referred faster. 23 Additional problem regarding the use of RT-PCR is the possibility of false-negative results (those infected with SARS-CoV-2 who have negative RT-PCR results). According to research, the proportion of false-negative results can range from 20% to 100%, with an average of 54% (happened in about 1 of 2 patients infected).…”