Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19.
Level 3 - non-randomized controlled study
Meta-analysis of observational comparative studies
PubMed 32511971 · doi:10.1016/j.cca.2020.06.009
What was done
Authors conducted a meta-analysis pooling laboratory data from 35 published articles encompassing 5,912 patients with COVID-19 to evaluate differences in clinical laboratory findings between severe and non-severe cases.
What was found
Severe cases showed higher levels of leukocyte (1.20-fold), neutrophil (1.33-fold), CRP (3.04-fold), PCT (2.00-fold), ESR (1.44-fold), AST (1.40-fold), ALT (1.34-fold), LDH (1.54-fold), CK (1.44-fold), CK-MB (1.39-fold), total bilirubin (1.14-fold), urea (1.28-fold), creatine (1.09-fold), PT (1.03-fold), D-dimer (2.74-fold), IL-1β (1.02-fold), IL-6 (1.93-fold), and IL-10 (1.55-fold). Severe cases showed lower levels of lymphocytes (1.44-fold), eosinophils (2.00-fold), monocytes (1.08-fold), hemoglobin (1.53-fold), platelets (1.15-fold), albumin (1.15-fold), APTT (1.02-fold), CD4 T cells (2.10-fold), and CD8 T cells (2.00-fold). Absolute values, confidence intervals, and p-values were not reported in the abstract.
Why it matters
This synthesis identifies accessible routine laboratory parameters, especially CRP, D-dimer, PCT, IL-6, LDH, and lymphocyte subsets, that track with COVID-19 severity to aid clinical risk stratification.
Limits
The analysis synthesizes observational studies from the early pandemic phase, which are vulnerable to confounding and varying definitions of severe disease. The abstract reports fold changes without confidence intervals, p-values, absolute values, or heterogeneity metrics. Timing of blood draws, patient comorbidities, and prognostic thresholds were not reported.
Cited by
- contradicts Common clinical features in COVID-19 patients include low albumin levels, low lymphocyte numbers, low neutrophil numbers, and decreased percentages of CD8-positive T cells.