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Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis.
Int J Environ Res Public Health. 2020 07 13; 17(14)IJ

Abstract

(1)

Background:

The global threat of Coronavirus disease 2019 (COVID-19) continues. The diversity of clinical characteristics and progress are reported in many countries as the duration of the pandemic is prolonged. We aimed to perform a novel systematic review and meta-analysis focusing on findings about correlations between clinical characteristics and laboratory features of patients with COVID-19. (2)

Methods:

We analyzed cases of COVID-19 in different countries by searching PubMed, Embase, Web of Science databases and Google Scholar, from the early stage of the outbreak to late March. Clinical characteristics, laboratory findings, and treatment strategies were retrospectively reviewed for the analysis. (3)

Results:

Thirty-seven (n = 5196 participants) COVID-19-related studies were eligible for this systematic review and meta-analysis. Fever, cough and fatigue/myalgia were the most common symptoms of COVID-19, followed by some gastrointestinal symptoms which are also reported frequently. Laboratory markers of inflammation and infection including C-reactive protein (CRP) (65% (95% confidence interval (CI) 56-81%)) were elevated, while lymphocyte counts were decreased (63% (95% CI 47-78%)). Meta-analysis of treatment approaches indicated that three modalities of treatment were predominantly used in the majority of patients with a similar prevalence, including antiviral agents (79%), antibiotics (78%), and oxygen therapy (77%). Age was negatively correlated with number of lymphocytes, but positively correlated with dyspnea, number of white blood cells, neutrophils, and D-dimer. Chills had been proved to be positively correlated with chest tightness, lung abnormalities on computed tomography (CT) scans, neutrophil/lymphocyte/platelets count, D-dimer and CRP, cough was positively correlated with sputum production, and pulmonary abnormalities were positively correlated with CRP. White blood cell (WBC) count was also positively correlated with platelet counts, dyspnea, and neutrophil counts with the respective correlations of 0.668, 0.728, and 0.696. (4)

Conclusions:

This paper is the first systematic review and meta-analysis to reveal the relationship between various variables of clinical characteristics, symptoms and laboratory results with the largest number of papers and patients until now. In elderly patients, laboratory and clinical characteristics indicate a more severe disease course. Moreover, treatments such as antiviral agents, antibiotics, and oxygen therapy which are used in over three quarters of patients are also analyzed. The results will provide "evidence-based hope" on how to manage this unanticipated and overwhelming pandemic.

Authors+Show Affiliations

Division of Urology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Korea.Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea.Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck 6020, Austria.The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK.Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain. ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain.Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France.Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Korea.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32668763

Citation

Ghayda, Ramy Abou, et al. "Correlations of Clinical and Laboratory Characteristics of COVID-19: a Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health, vol. 17, no. 14, 2020.
Ghayda RA, Lee J, Lee JY, et al. Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(14).
Ghayda, R. A., Lee, J., Lee, J. Y., Kim, D. K., Lee, K. H., Hong, S. H., Han, Y. J., Kim, J. S., Yang, J. W., Kronbichler, A., Smith, L., Koyanagi, A., Jacob, L., & Shin, J. I. (2020). Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 17(14). https://doi.org/10.3390/ijerph17145026
Ghayda RA, et al. Correlations of Clinical and Laboratory Characteristics of COVID-19: a Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 07 13;17(14) PubMed PMID: 32668763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. AU - Ghayda,Ramy Abou, AU - Lee,Jinhee, AU - Lee,Jun Young, AU - Kim,Da Kyung, AU - Lee,Keum Hwa, AU - Hong,Sung Hwi, AU - Han,Young Joo, AU - Kim,Jae Seok, AU - Yang,Jae Won, AU - Kronbichler,Andreas, AU - Smith,Lee, AU - Koyanagi,Ai, AU - Jacob,Louis, AU - Shin,Jae Il, Y1 - 2020/07/13/ PY - 2020/06/13/received PY - 2020/06/28/revised PY - 2020/07/02/accepted PY - 2020/7/17/entrez PY - 2020/7/17/pubmed PY - 2020/7/22/medline KW - COVID-19 KW - clinical characteristics KW - correlation KW - laboratory findings KW - treatment JF - International journal of environmental research and public health JO - Int J Environ Res Public Health VL - 17 IS - 14 N2 - (1) Background: The global threat of Coronavirus disease 2019 (COVID-19) continues. The diversity of clinical characteristics and progress are reported in many countries as the duration of the pandemic is prolonged. We aimed to perform a novel systematic review and meta-analysis focusing on findings about correlations between clinical characteristics and laboratory features of patients with COVID-19. (2) Methods: We analyzed cases of COVID-19 in different countries by searching PubMed, Embase, Web of Science databases and Google Scholar, from the early stage of the outbreak to late March. Clinical characteristics, laboratory findings, and treatment strategies were retrospectively reviewed for the analysis. (3) Results: Thirty-seven (n = 5196 participants) COVID-19-related studies were eligible for this systematic review and meta-analysis. Fever, cough and fatigue/myalgia were the most common symptoms of COVID-19, followed by some gastrointestinal symptoms which are also reported frequently. Laboratory markers of inflammation and infection including C-reactive protein (CRP) (65% (95% confidence interval (CI) 56-81%)) were elevated, while lymphocyte counts were decreased (63% (95% CI 47-78%)). Meta-analysis of treatment approaches indicated that three modalities of treatment were predominantly used in the majority of patients with a similar prevalence, including antiviral agents (79%), antibiotics (78%), and oxygen therapy (77%). Age was negatively correlated with number of lymphocytes, but positively correlated with dyspnea, number of white blood cells, neutrophils, and D-dimer. Chills had been proved to be positively correlated with chest tightness, lung abnormalities on computed tomography (CT) scans, neutrophil/lymphocyte/platelets count, D-dimer and CRP, cough was positively correlated with sputum production, and pulmonary abnormalities were positively correlated with CRP. White blood cell (WBC) count was also positively correlated with platelet counts, dyspnea, and neutrophil counts with the respective correlations of 0.668, 0.728, and 0.696. (4) Conclusions: This paper is the first systematic review and meta-analysis to reveal the relationship between various variables of clinical characteristics, symptoms and laboratory results with the largest number of papers and patients until now. In elderly patients, laboratory and clinical characteristics indicate a more severe disease course. Moreover, treatments such as antiviral agents, antibiotics, and oxygen therapy which are used in over three quarters of patients are also analyzed. The results will provide "evidence-based hope" on how to manage this unanticipated and overwhelming pandemic. SN - 1660-4601 UR - https://www.unboundmedicine.com/medline/citation/32668763/Correlations_of_Clinical_and_Laboratory_Characteristics_of_COVID_19:_A_Systematic_Review_and_Meta_Analysis_ DB - PRIME DP - Unbound Medicine ER -