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dc.contributor.authorMoutchia, Jude et al.
dc.date.accessioned2020-05-26T21:40:21Z
dc.date.available2020-05-26T21:40:21Z
dc.date.issued2020-04-29
dc.identifier.urihttps://doi.org/10.1101/2020.04.24.20078782en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12663/1609
dc.description.abstractBackground: To date, several clinical laboratory parameters associated with COVID-19 severity have been reported. However, these parameters have not been observed consistently across studies. The aim of this review was to assess clinical laboratory parameters which may serve as markers or predictors of severe or critical COVID-19 disease Methods: We conducted a systematic search of MEDLINE, Embase, Web of Science, CINAHL and Google Scholar databases from 2019 through April 18, 2020, and reviewed bibliographies of eligible studies, relevant systematic reviews, and the medRxiv pre-print server. We included hospital-based observational studies reporting clinical laboratory parameters of confirmed cases of COVID-19 and excluded studies having large proportions (>10%) of children and pregnant women. Two authors independently carried out screening of articles, data extraction and quality assessment. Meta-analyses were done using random effects model. Meta-median difference (MMD) and 95% confidence interval (CI) was calculated for each laboratory parameter. Results: Forty-five studies in 6 countries were included. Compared to non-severe COVID-19 cases, severe or critical COVID-19 disease was characterised by higher neutrophil count (MMD: 1.23 [95% CI: 0.58 to 1.88] ×109 cells/L), and lower lymphocyte and CD4 counts with MMD (95% CI) of -0.39 (-0.47, -0.31) ×109 cells/L and -204.9 (-302.6, -107.1) cells/μl, respectively. Other notable results were observed for C-reactive protein (MMD: 36.97 [95% CI: 27.58, 46.35] mg/L), interleukin-6 (MMD: 17.37 [95% CI: 4.74, 30.00] pg/ml,), Troponin I (MMD: 0.01 [0.00, 0.02] ng/ml), and D-dimer (MMD: 0.65 [0.45, 0.85] mg/ml). Conclusions and Relevance: Relative to non-severe COVID-19, severe or critical COVID-19 is characterised by increased markers of innate immune response, decreased markers of adaptive immune response, and increased markers of tissue damage and major organ failure. These markers could be used to recognise severe or critical disease and to monitor clinical course of COVID-19.en_US
dc.languageEnglishen_US
dc.subjectCOVID-19en_US
dc.subjectCoronavirusen_US
dc.subjectInfectious Diseasesen_US
dc.subjectSystematic Reviewen_US
dc.subjectMeta-Analysisen_US
dc.subjectClinical Laboratory Servicesen_US
dc.subjectLaboratoriesen_US
dc.titleClinicaLaboratory Parameters Associated with Severe or Critical Novel Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-analysisen_US
eihealth.countryGlobal (WHO/OMS)en_US
eihealth.categoryClinical characterization and managementen_US
eihealth.typePublished Articleen_US
eihealth.maincategorySave Lives / Salvar Vidasen_US
dc.relation.ispartofjournalmedRxiven_US


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