Background: Laboratory testing is commonly performed in patients with COVID-19. Each of the laboratory parameters has potential value for risk stratification and prediction of COVID-19 outcomes. This systematic review and meta-analysis aimed to evaluate the difference between these parameters in severe and nonsevere disease and to provide the optimal cutoff value for predicting severe disease. Method: We performed a systematic literature search through electronic databases. The variables of interest were serum procalcitonin, albumin, C-reactive protein (CRP), D-dimer, and lactate dehydrogenase (LDH) levels in each group of severity outcomes from COVID-19. Results: There were a total of 4848 patients from 23 studies. Our meta-analysis suggest that patients with severe COVID-19 infections have higher procalcitonin, (mean difference 0.07; 95% CI 0.05-0.10; p < 0.00001), CRP (mean difference 36.88; 95% CI 29.10-44.65; p < 0.00001), D-Dimer (mean difference 0.43; 95% CI 0.31-0.56; p < 0.00001), and LDH (mean difference 102.79; 95% CI 79.10-126.49; p < 0.00001) but lower levels of albumin (mean difference −4.58; 95% CI −5.76 to −3.39; p < 0.00001) than those with nonsevere COVID-19 infections. The cutoff values for the parameters were 0.065 ng/mL for procalcitonin, 38.85 g/L for albumin, 33.55 mg/L for CRP, 0.635 μ/L for D-dimer, and 263.5 U/L for LDH, each with high sensitivity and specificity. Conclusion: This meta-analysis suggests elevated procalcitonin, CRP, D-dimer, and LDH and decreased albumin can be used for predicting severe outcomes in COVID-19.

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Background and aims The coronavirus disease 2019 (COVID-19) pandemic has caused a significant impact on all aspects of life. One of the comorbidities associated with severe outcome and mortality of COVID-19 is diabetes. Metformin is one of the drugs which is most commonly used for the treatment of diabetes patients. This study aims to analyze the potential benefit of metformin use in reducing the mortality rate from COVID-19 infection. Methods We systematically searched the Google Scholar database using specific keywords related to our aims until August 3rd, 2020. All articles published on COVID-19 and metformin were retrieved. Statistical analysis was done using Review Manager 5.4 software. Results A total of 5 studies with a total of 6937 patients were included in our analysis. Our meta-analysis showed that metformin use is associated with reduction in mortality rate from COVID-19 infections [RR 0.54 (95% CI 0.32–0.90), p = 0.02, I 2 = 54%, random-effect modelling]. Conclusion Metformin has shown benefits in reducing the mortality rate from COVID-19 infections. Patients with diabetes should be advised to continue taking metformin drugs despite COVID-19 infection status.

Background and aims The coronavirus disease 2019 (COVID-19) number of death cases is still increasing. One of the comorbidities associated with severe outcome and mortality of COVID-19 is dyslipidemia. Statin is one of the drugs which is most commonly used for the treatment of dyslipidemic patients. This study aims to analyze the association between statin use and in-hospital outcomes of COVID-19 infection. Methods We systematically searched the Google Scholar database using specific keywords related to our aims until August 1st, 2020. All articles published on COVID-19 and statin were retrieved. Statistical analysis was done using Review Manager 5.4 software. Results A total of 9 studies with a total of 3449 patients were included in our analysis. Our meta-analysis showed that statin use did not improve severity outcome [OR 1.64 (95% CI 0.51–5.23), p = 0.41, I 2 = 93%, random-effect modelling] nor mortality rate from COVID-19 infection [OR 0.78 (95% CI 0.50–1.21), p = 0.26, I 2 = 0%, fixed-effect modelling]. Conclusion Statin use did not improve in-hospital outcomes of COVID-19 infections. Patients with dyslipidemia should continue taking statin drugs despite COVID-19 infection status, given its beneficial effects on cardiovascular outcomes.

Background and aims The number of positive and death cases from coronavirus disease 2019 (COVID-19) is still increasing. The identification of risk factors for severe outcomes is important. Dyslipidemia has been shown as a long-known risk factor for cardiovascular disease. The aim of this study is to analyze the potential association between dyslipidemia and the severity of COVID-19 infection. Methods We systematically searched the PubMed database using specific keywords related to our aims until July 9th, 2020. All articles published on COVID-19 and dyslipidemia were retrieved. Statistical analysis was done using Review Manager 5.4 software. Results A total of 7 studies with a total of 6922 patients were included in our analysis. Our meta-analysis showed that dyslipidemia is associated with severe COVID-19 infections [RR 1.39 (95% CI 1.03–1.87), p = 0.03, I 2 = 57%, random-effect modelling]. Conclusion Dyslipidemia increases the risk of the development of severe outcomes from COVID-19 infections. Patients with dyslipidemia should be monitored closely to minimize the risk of COVID-19.

Letter to the Editor Anemia is associated with severe coronavirus disease 2019 (COVID-19) infectionDear Editor, Until recently, the number of positive and death cases from coronavirus disease 2019 (COVID-19) is still increasing. This pandemic disease has caused a significant impact and burden on all aspects of life, especially on the economic and health aspect. Therefore, identification of risk factors that contribute to the development of the severe disease is very important to enable risk stratification, optimize hospital resources reallocation, and guide public health recommendations and interventions. A previous study has shown that anemia was common in patients with community-acquired pneumonia (CAP) and was associated with a higher 90-day mortality rate [1]. Unfortunately, no study provides clear evidence regarding the link between anemia and COVID-19. This article aims to explore the potential association between anemia and the severity of COVID-19 infection.A search of the literature was conducted on Google scholar using the keywords "anemia" OR "hematologic" OR "clinical characteristics" OR "comorbidities" OR "risk factors" AND "coronavirus disease 2019" OR "COVID-19", until July 21st, 2020) with language restricted to English only. The title, abstract, and full text of all articles identified that matched the search criteria were assessed, and those reporting the rate of anemia in COVID-19 patients with a clinically validated definition of "severe disease" were included in this meta-analysis.A meta-analysis was performed using Review Manager 5.4 (Cochrane Collaboration) software. Dichotomous variables were calculated using the Mantel-Haenszel formula with random-effects models. We used the I 2 statistic to assess the heterogeneity, value of < 25 %, 26-50 %, and > 50 % considered as low, moderate, and high degrees of heterogeneity, respectively. The effect estimate was reported as odds ratio (OR) along with its 95 % confidence intervals (CIs) for dichotomous variables, respectively. P-value was two-tailed, and the statistical significance set at ≤0.05.A total of 17,200 records were obtained through systematic electronic searches and other ways. After screening titles, abstracts, and full texts, 7 studies [2-8] with a total of 9,912 COVID-19 patients were * Corresponding author.

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