The laboratory findings and different COVID-19 severities: a systematic review and meta-analysis

Kazemi, Erfan; Soldoozi Nejat, Reihane; Ashkan, Fatemeh; Sheibani, Hossein

BACKGROUND: Abnormal laboratory findings are common in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this systematic review was to investigate the effect of the level of some laboratory factors (C-reactive protein (CRP), creatinine, leukocyte count, hemoglobin, and platelet count) on the severity and outcome of coronavirus disease 2019 (COVID-19). METHODS: We searched PubMed, Web of Science, Scopus, and Google Scholar. We collected the articles published before May 26, 2020. We gathered the laboratory factors in groups of patients with COVID-19, and studied the relation between level of these factors with severity and outcome of the disease. RESULTS: Mean CRP level, creatinine, hemoglobin, and the leukocytes count in the critically ill patients were significantly higher than those of the other groups (non-critical patients); mean CRP = 54.81 mg/l, mean creatinine = 86.82 μmol/l, mean hemoglobin = 144.05 g/l, and mean leukocyte count = 7.41 × 10(9). The lymphocyte count was higher in patients with mild/moderate disease (mean: 1.32 × 10(9)) and in the invasive ventilation group (mean value of 0.72 × 10(9)), but it was considerably lower than those of the other two groups. The results showed that the platelet count was higher in critically ill patients (mean value of 205.96 × 10(9)). However, the amount was lower in the invasive ventilation group compared with the other groups (mean level = 185.67 × 10(9)). CONCLUSION: With increasing disease severity, the leukocyte count and the level of CRP increase significantly and the lymphocyte count decreases. There seems to be a significant relation between platelet level, hemoglobin, and creatinine level with severity of the disease. However, more studies are required to confirm this.