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Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis

(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...

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Autores principales: Ghayda, Ramy Abou, Lee, Jinhee, Lee, Jun Young, Kim, Da Kyung, Lee, Keum Hwa, Hong, Sung Hwi, Han, Young Joo, Kim, Jae Seok, Yang, Jae Won, Kronbichler, Andreas, Smith, Lee, Koyanagi, Ai, Jacob, Louis, Shin, Jae Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400047/
https://www.ncbi.nlm.nih.gov/pubmed/32668763
http://dx.doi.org/10.3390/ijerph17145026
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author Ghayda, Ramy Abou
Lee, Jinhee
Lee, Jun Young
Kim, Da Kyung
Lee, Keum Hwa
Hong, Sung Hwi
Han, Young Joo
Kim, Jae Seok
Yang, Jae Won
Kronbichler, Andreas
Smith, Lee
Koyanagi, Ai
Jacob, Louis
Shin, Jae Il
author_facet Ghayda, Ramy Abou
Lee, Jinhee
Lee, Jun Young
Kim, Da Kyung
Lee, Keum Hwa
Hong, Sung Hwi
Han, Young Joo
Kim, Jae Seok
Yang, Jae Won
Kronbichler, Andreas
Smith, Lee
Koyanagi, Ai
Jacob, Louis
Shin, Jae Il
author_sort Ghayda, Ramy Abou
collection PubMed
description (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.
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spelling pubmed-74000472020-08-23 Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis Ghayda, Ramy Abou Lee, Jinhee Lee, Jun Young Kim, Da Kyung Lee, Keum Hwa Hong, Sung Hwi Han, Young Joo Kim, Jae Seok Yang, Jae Won Kronbichler, Andreas Smith, Lee Koyanagi, Ai Jacob, Louis Shin, Jae Il Int J Environ Res Public Health Article (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. MDPI 2020-07-13 2020-07 /pmc/articles/PMC7400047/ /pubmed/32668763 http://dx.doi.org/10.3390/ijerph17145026 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ghayda, Ramy Abou
Lee, Jinhee
Lee, Jun Young
Kim, Da Kyung
Lee, Keum Hwa
Hong, Sung Hwi
Han, Young Joo
Kim, Jae Seok
Yang, Jae Won
Kronbichler, Andreas
Smith, Lee
Koyanagi, Ai
Jacob, Louis
Shin, Jae Il
Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title_full Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title_fullStr Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title_full_unstemmed Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title_short Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis
title_sort correlations of clinical and laboratory characteristics of covid-19: a systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400047/
https://www.ncbi.nlm.nih.gov/pubmed/32668763
http://dx.doi.org/10.3390/ijerph17145026
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