Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
School of Medicine, Tehran University of Medical sciences, Tehran, Iran.
Adv Exp Med Biol. 2021;1318:369-402. doi: 10.1007/978-3-030-63761-3_22.
Coronavirus disease 2019 (COVID-19) pandemic continues devastating effects on healthcare systems. Such a crisis calls for an urgent need to develop a risk stratification tool. The present chapter aimed to identify laboratory and clinical correlates of adverse outcomes in patients with COVID-19. To this end, we conducted a systematic evaluation of studies that investigated laboratory abnormalities in patients with COVID-19 and compared i. patients with a severe form of disease and patients with a non-severe form of the disease, ii. patients who were in critical condition and patients who were not in critical condition, and iii. patients who survived and patients who died. We included 54 studies in the data synthesis. Compared to patients with a non-severe form of COVID-19, patients who had a severe form of disease revealed higher values for white blood cells (WBC), polymorphonuclear leukocytes (PMN), total bilirubin, alanine aminotransferase (ALT), creatinine, troponin, procalcitonin, lactate dehydrogenase (LDH), and D-dimer. By contrast, platelet count, lymphocyte count, and albumin levels were decreased in patients with a severe form of COVID-19. Also, patients with a severe phenotype of disease were more likely to have diabetes, chronic heart disease, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, hypertension, chronic kidney disease (CKD), and malignancy. Compared to patients who survived, patients who died had higher WBC, PMN, total bilirubin, ALT, procalcitonin, IL-6, creatinine, PT, lymphocyte count, platelet count, and albumin. Also, non-survivors revealed a higher prevalence of diabetes, chronic heart disease, COPD, cerebrovascular disease, and CKD. Meta-analyses identified several laboratory parameters that might help the prediction of severe, critical, and lethal phenotypes of COVID-19. These parameters correlate with the immune system function, inflammation, coagulation, and liver and kidney function.
新型冠状病毒病（COVID-19）大流行继续对医疗系统造成破坏性影响。这种危机迫切需要开发一种风险分层工具。本章旨在确定 COVID-19 患者不良结局的实验室和临床相关因素。为此，我们对研究 COVID-19 患者实验室异常的研究进行了系统评价，并比较了 i. 疾病严重程度不同的患者和疾病非严重程度的患者，ii. 病情危急的患者和病情不危急的患者，以及 iii. 存活的患者和死亡的患者。我们将 54 项研究纳入数据综合分析。与非严重 COVID-19 患者相比，患有严重疾病的患者白细胞（WBC）、中性粒细胞（PMN）、总胆红素、丙氨酸氨基转移酶（ALT）、肌酐、肌钙蛋白、降钙素原、乳酸脱氢酶（LDH）和 D-二聚体的水平更高。相比之下，严重 COVID-19 患者的血小板计数、淋巴细胞计数和白蛋白水平降低。此外，严重疾病表型的患者更可能患有糖尿病、慢性心脏病、慢性阻塞性肺疾病（COPD）、脑血管疾病、高血压、慢性肾脏病（CKD）和恶性肿瘤。与存活的患者相比，死亡的患者白细胞（WBC）、PMN、总胆红素、ALT、降钙素原、IL-6、肌酐、PT、淋巴细胞计数、血小板计数和白蛋白更高。此外，非幸存者糖尿病、慢性心脏病、COPD、脑血管疾病和 CKD 的患病率更高。荟萃分析确定了一些可能有助于预测 COVID-19 严重、危急和致命表型的实验室参数。这些参数与免疫系统功能、炎症、凝血以及肝肾功能有关。
