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Crucial laboratory parameters in COVID-19 diagnosis and prognosis: An updated meta-analysis

Authors
  • Soraya, Gita Vita1
  • Ulhaq, Zulvikar Syambani2
  • 1 Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, 90245, Indonesia
  • 2 Department of Biochemistry, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim Islamic State University of Malang, Batu, East Java, 65151, Indonesia
Type
Published Article
Journal
Medicina Clinica (English Ed.)
Publisher
Elsevier España, S.L.U.
Publication Date
Aug 22, 2020
Volume
155
Issue
4
Pages
143–151
Identifiers
DOI: 10.1016/j.medcle.2020.05.004
PMID: 32864456
PMCID: PMC7442896
Source
PubMed Central
Keywords
License
Unknown

Abstract

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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