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Crucial laboratory parameters in COVID-19 diagnosis and prognosis: An updated meta-analysis
Gita Vita Soraya1, Zulvikar Syambani Ulhaq2
1Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia.
Insights
Laboratory parameters like thrombocyte count are crucial for diagnosing and predicting COVID-19 severity. Low leukocyte and neutrophil counts suggest infection, while higher counts indicate disease progression, aiding in COVID-19 case detection and management.
Area of Science:
- Medical laboratory science
- Infectious disease diagnostics
- Clinical pathology
Background:
- Laboratory parameters play a vital role in the detection and assessment of coronavirus disease 2019 (COVID-19).
- Distinguishing between COVID-19 pneumonia and other forms of pneumonia, as well as differentiating between severe and non-severe COVID-19 cases, is critical for effective patient management.
Purpose of the Study:
- To investigate the differences in common laboratory parameters between COVID-19 pneumonia and non-COVID-19 pneumonia.
- To identify laboratory parameter variations between severe and non-severe cases of COVID-19.
Main Methods:
- A systematic review and meta-analysis of relevant studies published until March 2020.
- Parameters analyzed included leukocyte, neutrophil, thrombocyte, and lymphocyte counts, alongside C-reactive protein (CRP), procalcitonin (PCT), and D-dimer levels.
- The random-effect model (REM) was employed due to observed heterogeneity in study data.
Main Results:
- COVID-19 pneumonia cases exhibited significantly lower leukocyte, neutrophil, and platelet counts compared to non-COVID-19 pneumonia.
- Severe COVID-19 cases were associated with significantly lower lymphocyte and thrombocyte counts.
- Conversely, severe COVID-19 cases showed significantly higher leukocyte, neutrophil, D-dimer, and CRP levels compared to non-severe cases.
Conclusions:
- Thrombocyte count is a significant indicator for both the diagnosis and prognosis of COVID-19.
- Low leukocyte and neutrophil counts may signify COVID-19 infection, whereas elevated levels suggest disease progression.
- While lymphocyte, D-dimer, and CRP levels may not be diagnostic, they are indicative of COVID-19 severity, warranting further investigation in future studies.
Introduction And Objectives:
Common laboratory parameters are crucial in aiding coronavirus disease 2019 (COVID-19) case detection. This study aimed to determine the differences between laboratory parameters in (1) COVID-19 versus non-COVID-19 pneumonia, and (2) severe versus non-severe COVID-19 cases.
Methods:
Studies were collected until March 2020, and retrieved parameters include leukocyte, neutrophil, thrombocyte, and lymphocyte counts in addition to C-reactive protein (CRP), procalcitonin (PCT) and D-dimer levels. In the presence of heterogeneity, the random-effect model (REM) was used instead of the fixed-effect model (FEM).
Results:
Seven studies in the first analysis showed significantly lower leukocyte, neutrophil and platelet counts in COVID-19 pneumonia (SMD=-0.42, 95%CI -0.60 to -0.25, p<0.00001, SMD=-0.23, 95%CI -0.41 to -0.06, p=0.01, SMD=-0.54, 95%CI -0.91 to -0.16, p=0.0005) compared to non-COVID-19 pneumonia. Twenty-six studies in the second analysis showed significantly lower lymphocyte and thrombocyte counts (SMD=-0.56, 95%CI -0.71 to -0.40, p<0.0001, SMD=-0.32, 95%CI -0.49 to -0.15, p=0.0002) and significantly higher leukocyte, neutrophil, D-dimer, and CRP (SMD=0.31, 95%CI 0.07-0.56, p=0.01; SMD=0.44, 95%CI 0.24-0.64, p<0.0001; SMD=0.53, 95%CI 0.31-0.75, p<0.00001; SMD=0.97, 95%CI 0.70-1.24, p<0.00001) in severe COVID-19 compared to non-severe COVID-19.
Conclusions:
In conclusion, thrombocyte count is key in both diagnosis and prognosis. Low leukocyte and neutrophil counts are markers of COVID-19 infection, but contrastingly higher counts indicate progressive COVID-19. And although lymphocyte, D-dimer and CRP levels did not demonstrate diagnostic value, all indicate severity of COVID-19. Confirmation of these findings should be performed in future studies.
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