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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
Platelet count is crucial for diagnosing and predicting coronavirus disease 2019 (COVID-19) severity. Lower leukocyte and neutrophil counts suggest COVID-19 infection, while higher counts indicate disease progression.
Area of Science:
- Medical laboratory science
- Infectious disease diagnostics
- Critical care medicine
Background:
- Laboratory parameters are vital for diagnosing coronavirus disease 2019 (COVID-19).
- Differentiating COVID-19 from non-COVID-19 pneumonia and assessing disease severity requires understanding key biomarkers.
Purpose of the Study:
- To compare laboratory parameters between COVID-19 and non-COVID-19 pneumonia.
- To identify laboratory differences between severe and non-severe COVID-19 cases.
Main Methods:
- Systematic review and meta-analysis of studies published until March 2020.
- Analysis of leukocyte, neutrophil, thrombocyte, lymphocyte counts, C-reactive protein (CRP), procalcitonin (PCT), and D-dimer levels.
- Random-effect model applied due to heterogeneity.
Main Results:
- COVID-19 pneumonia cases showed significantly lower leukocyte, neutrophil, and platelet counts compared to non-COVID-19 pneumonia.
- Severe COVID-19 cases exhibited significantly lower lymphocyte and thrombocyte counts.
- Severe COVID-19 cases also showed significantly higher leukocyte, neutrophil, D-dimer, and CRP levels.
Conclusions:
- Thrombocyte count is a key indicator for both COVID-19 diagnosis and prognosis.
- Low leukocyte and neutrophil counts may indicate COVID-19 infection, whereas elevated levels suggest disease progression.
- Lymphocyte, D-dimer, and CRP levels, while not diagnostic, are indicative of COVID-19 severity.
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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