Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Road, Wuhan 430022, P.R. China.
Clin Chem Lab Med. 2020 Jul 28;58(8):1172-1181. doi: 10.1515/cclm-2020-0338.
Objective Recently, there have been several studies on the clinical characteristics of patients with coronavirus disease 2019 (COVID-19); however, these studies have mainly been concentrated in Wuhan, China; the sample sizes of each article were different; and the reported clinical characteristics, especially blood biochemical indices, were quite different. This study aimed to summarize the blood biochemistry characteristics of COVID-19 patients by performing a systemic review and meta-analysis of published studies. Methods Comprehensive studies were screened from PubMed, Embase, and Cochrane Library through March 11, 2020. The inclusion criteria included studies investigating the biochemical indexes of patients with COVID-19. The statistical software R3.6.3 was used for meta-analysis. Results Ten studies including 1745 COVID-19 patients met the inclusion criteria for our meta-analysis. Meta-analysis showed that 16% and 20% of patients with COVID-19 had alanine transaminase (ALT) and aspartate aminotransferase (AST) levels higher than the normal range, respectively. Thirty-four percent of patients showed albumin (ALB) levels lower than the normal range, and 6% of patients showed abnormal total bilirubin (TBil) levels. The levels of creatinine (CRE) were increased in 8% of patients. The creatine kinase (CK) level of 13% of patients exceeded the normal range, and 52% of patients had elevated lactate dehydrogenase (LDH) levels. In addition, six studies met the inclusion criteria for the systemic review evaluating the relevance between LDH levels and the severity of COVID-19, and all six studies showed a positive association between these two factors. Conclusions Some patients with COVID-19 had different degrees of blood biochemical abnormalities, which might indicate multiple organ dysfunction. Some biochemical indexes, such as abnormal ALB and LDH, could reflect the severity of the disease to a certain extent. These blood biochemical indicators should be considered in the clinical management of the disease.
目的 最近有几项关于 2019 年冠状病毒病（COVID-19）患者临床特征的研究，但这些研究主要集中在中国武汉；各文章的样本量不同；报告的临床特征，尤其是血液生化指标差异较大。本研究旨在通过对已发表研究进行系统评价和荟萃分析，总结 COVID-19 患者的血液生化特征。
方法 从 2020 年 3 月 11 日的 PubMed、Embase 和 Cochrane Library 中筛选全面研究。纳入标准包括研究 COVID-19 患者生化指标的研究。使用 R3.6.3 统计软件进行荟萃分析。
结果 纳入的 10 项研究共包括 1745 例 COVID-19 患者，符合荟萃分析的纳入标准。荟萃分析显示，16%和 20%的 COVID-19 患者丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）水平高于正常值。34%的患者白蛋白（ALB）水平低于正常值，6%的患者总胆红素（TBil）水平异常。8%的患者肌酐（CRE）水平升高。13%的患者肌酸激酶（CK）水平超过正常值，52%的患者乳酸脱氢酶（LDH）水平升高。此外，有 6 项研究符合系统评价纳入标准，评估 LDH 水平与 COVID-19 严重程度的相关性，所有 6 项研究均显示两者之间存在正相关。
结论 一些 COVID-19 患者存在不同程度的血液生化异常，可能提示多器官功能障碍。一些生化指标，如异常的 ALB 和 LDH，在一定程度上可以反映疾病的严重程度。这些血液生化指标应在疾病的临床管理中加以考虑。
