Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
BMC Pulm Med. 2021 Jan 22;21(1):37. doi: 10.1186/s12890-020-01389-z.
COVID-19 is a systemic viral infection which mainly targets the human respiratory system with many secondary clinical manifestations especially affecting the hematopoietic system and haemostasis. Few studies have highlighted the prognostic value of blood findings such as lymphopenia, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, LDH, CRP, cardiac troponin, low-density lipoproteins and chest radiographic abnormality. A study of progressions of blood and radiological results may help to identify patients at high risk of severe outcomes. This systematic review aimed to assess the temporal progression of blood and radiology findings of patients with COVID-19.
Comprehensive systematic literature search was conducted on Medline, Embase and Cochrane databases to identify articles published for peripheral blood investigation and radiological results of COVID-19 patients.
A total of 27 studies were included in this review. The common laboratory features reported include lymphopenia, elevated levels of C-reactive proteins and lactate dehydrogenase. For radiological signs, ground-glass opacifications, consolidations, and crazy paving patterns were frequently reported. There is a correlation between lymphocyte count, neutrophil count and biomarkers such as C-reactive proteins and lactate dehydrogenase; at a later phase of the disease (more than 7 days since onset of symptoms), lymphopenia worsens while neutrophil count, C-reactive protein levels and lactate dehydrogenase levels increase. Frequencies of ground-glass opacifications and ground-glass opacifications with consolidations decrease at a later phase of the disease while that of consolidation and crazy paving pattern rises as the disease progresses. More extensive lung involvement was also seen more frequently in the later phases.
The correlation between temporal progression and the reported blood and radiological results may be helpful to monitor and evaluate disease progression and severity.
COVID-19 是一种全身性病毒感染,主要靶向人体呼吸系统,具有许多继发性临床表现,尤其影响造血系统和止血功能。少数研究强调了血液发现(如淋巴细胞减少、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、LDH、CRP、肌钙蛋白、低密度脂蛋白和胸部 X 线异常)的预后价值。对血液和影像学结果的进展进行研究可能有助于识别高风险重症患者。本系统综述旨在评估 COVID-19 患者的血液和影像学结果的时间进展。
对 Medline、Embase 和 Cochrane 数据库进行全面系统文献检索,以确定发表的有关 COVID-19 患者外周血检查和影像学结果的文章。
本综述共纳入 27 项研究。报告的常见实验室特征包括淋巴细胞减少、C 反应蛋白和乳酸脱氢酶水平升高。影像学征象方面,磨玻璃影、实变和铺路石征较为常见。淋巴细胞计数、中性粒细胞计数与 C 反应蛋白和乳酸脱氢酶等标志物之间存在相关性;在疾病后期(症状出现后 7 天以上),淋巴细胞计数恶化,而中性粒细胞计数、C 反应蛋白水平和乳酸脱氢酶水平升高。疾病后期,磨玻璃影和磨玻璃影伴实变的频率降低,而实变和铺路石征的频率增加。随着疾病的进展,更广泛的肺受累也更常见。
时间进展与报告的血液和影像学结果之间的相关性可能有助于监测和评估疾病的进展和严重程度。