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Laboratory findings of COVID-19: a systematic review and meta-analysis.
Scand J Clin Lab Invest. 2020 10; 80(6):441-447.SJ

Abstract

The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased C-reactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.

Authors+Show Affiliations

Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Clinical Laboratories, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Clinical Laboratories, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32449374

Citation

Zhang, Zu-Li, et al. "Laboratory Findings of COVID-19: a Systematic Review and Meta-analysis." Scandinavian Journal of Clinical and Laboratory Investigation, vol. 80, no. 6, 2020, pp. 441-447.
Zhang ZL, Hou YL, Li DT, et al. Laboratory findings of COVID-19: a systematic review and meta-analysis. Scand J Clin Lab Invest. 2020;80(6):441-447.
Zhang, Z. L., Hou, Y. L., Li, D. T., & Li, F. Z. (2020). Laboratory findings of COVID-19: a systematic review and meta-analysis. Scandinavian Journal of Clinical and Laboratory Investigation, 80(6), 441-447. https://doi.org/10.1080/00365513.2020.1768587
Zhang ZL, et al. Laboratory Findings of COVID-19: a Systematic Review and Meta-analysis. Scand J Clin Lab Invest. 2020;80(6):441-447. PubMed PMID: 32449374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laboratory findings of COVID-19: a systematic review and meta-analysis. AU - Zhang,Zu-Li, AU - Hou,Yu-Lei, AU - Li,De-Tao, AU - Li,Feng-Zeng, Y1 - 2020/05/23/ PY - 2020/5/26/pubmed PY - 2020/10/21/medline PY - 2020/5/26/entrez KW - C-reactive protein KW - COVID-2019 KW - SARS-CoV-2 KW - laboratory findings KW - lactate dehydrogenase KW - lymphopenia SP - 441 EP - 447 JF - Scandinavian journal of clinical and laboratory investigation JO - Scand J Clin Lab Invest VL - 80 IS - 6 N2 - The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased C-reactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit. SN - 1502-7686 UR - https://www.unboundmedicine.com/medline/citation/32449374/Laboratory_findings_of_COVID_19:_a_systematic_review_and_meta_analysis_ L2 - https://www.tandfonline.com/doi/full/10.1080/00365513.2020.1768587 DB - PRIME DP - Unbound Medicine ER -