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Meta-analysis of laboratory results in patients with severe coronavirus disease 2019
Yun Huang1, Yuyu Zhang1, Lili Ma1
1Department of Pharmacy, Ningbo Medical Center, Li Huili Hospital, Ningbo, Zhejiang 315040, P.R. China.
Insights
Certain lab results like high white blood cell counts and C-reactive protein indicate a higher risk for severe COVID-19. These markers can help predict disease progression for better clinical intervention.
Area of Science:
- Medical laboratory science
- Infectious disease research
- Clinical diagnostics
Background:
- Coronavirus disease 2019 (COVID-19) presents a spectrum of severity, from moderate to critical.
- Identifying early indicators of severe COVID-19 is crucial for timely clinical intervention and resource allocation.
- Laboratory findings play a key role in assessing disease severity and patient outcomes.
Purpose of the Study:
- To compare laboratory results between patients with severe and moderate COVID-19.
- To identify specific laboratory markers associated with severe COVID-19.
- To evaluate the utility of these markers for predicting disease progression.
Main Methods:
- A meta-analysis was performed on data from 6 studies, including 1,534 COVID-19 patients.
- Laboratory results from December 2019 to May 2020 were compiled from Medline, Embase, and Cochrane Library databases.
- Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using Review Manager 5.3.
Main Results:
- Leukocytosis (OR=3.44), lymphocytopenia (OR=4.39), elevated procalcitonin (PCT) (OR=5.28), C-reactive protein (CRP) (OR=3.99), aspartate aminotransferase (AST) (OR=3.02), and lactic dehydrogenase (LDH) (OR=8.33) were significantly associated with severe COVID-19.
- These markers indicated a 3- to 8-fold increased risk of severe infection.
- The pooled analysis revealed significant differences in these laboratory parameters between severe and moderate cases.
Conclusions:
- Elevated levels of white blood cell count, lymphocyte count, CRP, PCT, LDH, and AST are strong predictors of severe COVID-19.
- Serial monitoring of these laboratory values can aid in predicting disease progression.
- These findings support the use of routine laboratory tests for risk stratification in COVID-19 patients.
Abstract:
The aim of the present study was to analyze the differences in laboratory results between patients with severe and moderate coronavirus disease 2019 (COVID-19) for clinical intervention. The laboratory results of patients with COVID-19 between December 2019 and May 2020 were assembled from the Medline, Embase and Cochrane Library databases. A meta-analysis was conducted, calculating the individual and pooled odds ratios (ORs) with relative 95% confidence intervals (95% CIs) using Review Manager 5.3. The available data of 1,534 patients from 6 studies were included in this analysis. The results demonstrated that the incidence of leukocytosis, lymphocytopenia, increased procalcitonin (PCT), C-reactive protein (CRP), aspartate aminotransferase (AST) and lactic dehydrogenase (LDH) levels was associated with a nearly 3-fold (OR=3.44; 95% CI: 2.15-5.49), 4-fold (OR=4.39; 95% CI: 1.82-10.60), 5-fold (OR=5.28; 95% CI: 3.42-8.15), 4-fold (OR=3.99; 95% CI: 2.61-6.12), 3-fold (OR=3.02; 95% CI: 2.13-4.26) and 8-fold (OR=8.33; 95% CI: 1.75-39.69) higher risk of severe COVID-19 infection, respectively. These findings indicated that serial white blood cell count, lymphocyte count, CRP, PCT, LDH and AST measurements may be useful for predicting progression towards a more severe form of COVID-19.
