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

Authors
 Ramy Abou Ghayda 1 2  ;  Jinhee Lee 3  ;  Jun Young Lee 4  ;  Da Kyung Kim 5  ;  Keum Hwa Lee 6  ;  Sung Hwi Hong 2  ;  Young Joo Han 7  ;  Jae Seok Kim 4  ;  Jae Won Yang 4  ;  Andreas Kronbichler 8  ;  Lee Smith 9  ;  Ai Koyanagi 10 11  ;  Louis Jacob 10 12  ;  Jae Il Shin 6 
Citation
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol.17(14) : 5026, 2020-07 
Journal Title
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 
ISSN
 1661-7827 
Issue Date
2020-07
MeSH
Age Factors ; Betacoronavirus ; C-Reactive Protein / analysis ; Chills / virology ; Coronavirus Infections / diagnosis* ; Coronavirus Infections / therapy* ; Cough / virology ; Dyspnea / virology ; Fibrin Fibrinogen Degradation Products / analysis ; Humans ; Inflammation / virology ; Leukocyte Count ; Lymphocyte Count ; Pandemics ; Platelet Count ; Pneumonia, Viral / diagnosis* ; Pneumonia, Viral / therapy*
Keywords
COVID-19 ; clinical characteristics ; correlation ; laboratory findings ; treatment
Abstract
(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.
Files in This Item:
T202002820.pdf Download
DOI
10.3390/ijerph17145026
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lee, Keum Hwa(이금화) ORCID logo https://orcid.org/0000-0002-1511-9587
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179528
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