A systematic review of clinical and laboratory parameters associated with increased severity among COVID-19 patients

Abstract

Background and aims Corona virus disease 2019 (COVID-19) has been an extremely difficult pandemic to contain and it has affected more than 148 countries worldwide. The main aim of this systematic review is to provide a comprehensive summary of clinical and laboratory parameters that are associated with and indicative of increased severity among COVID-19 patients. Material and methods All the available data from high-quality research articles relevant to the epidemiology, demographics, trends in hospitalization and outcomes, clinical signs and symptoms, diagnostic methods and treatment methods of COVID-19 were retrieved and evaluated for inclusion. Results As per our review, the mean age of patients in the severe group was 59.3 years compared to 46.5 years in non severe group. COVID-19 was more severe among men than women. Clinical presentation was variable among different studies. and dyspnea was the factor indicating severe disease. Laboratory parameters associated with increased severity were lymphopenia <0.8 × 10 9 /L, thrombocytopenia 100 × 10 9 /L, leucocytosis TC > 11 × 10 9 /L, procalcitonin >0.5 ng/mL, d dimer >2 mcg/mL, aspartate transaminase elevation >150U/L, LDH >250U/L. Conclusion This systematic review suggests that COVID-19 is a disease with varied clinical presentation and laboratory parameters. The commonest clinical symptoms were fever, cough and dyspnea. The laboratory parameters associated with severe disease were lymphopenia, elevated LDH, D dimer and Procalcitonin.

Metabolic Perturbation Associated With COVID-19 Disease Severity and SARS-CoV-2 Replication

“…Therefore, we next measured the expression of carbohydrate transporters, GLUT1 (SLC2A1) and xCT (SLC7A11) that were one of the key transporters of glucose/mannose and antiporter of glutamate respectively, in PBMCs of HC (n=19), HC-CoV-2 Ab+ (n=9) and COVID-19 patients: mild (n=21) and severe (n=11) using flow cytometry. Like other studies ( 28 , 29 ), the relative frequency of lymphocytes significantly decreased in COVID-19 patients than HCs, which was more prominent in severe patients ( Fig 4 a). In total lymphocytic populations the CD3 + T-cells were significantly reduced in COVID-19 severe patients compared to mild patients and HCs ( Fig 4 b).…”

“…The study population included healthy controls (HC, n=31), SARS-CoV-2 PCR positive hospitalized-mild (mild, O 2 consumption<4lit/min, n=29) and hospitalized-severe (severe, O 2 consumption≥4lit/min, n=12) patients. The mild and severe groups were matched by gender (male: 79% vs 91%, p=0.6514), BMI [median (IQR): 29 ( 25 , 26 , 27 , 28 , 29 , 30 , 31 ) vs 28 ( 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ); p=0.8622] and age [median (IQR): 57 (44-63) vs 57 (52-69); p=0.2831]. The HC has significantly lower age [median (IQR): 48 ( 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 )], lower BMI [median (IQR): 24 ( 21 , 22 , 23 , 24 , 25 )] ( Table S3 ).…”

Bibliometric Analysis of SARS, MERS, and COVID-19 Studies from India and Connection to Sustainable Development Goals

“…Such collaboration and active data-sharing policies are essential aspects to fight this pandemic and other future crises [67][68][69]. The high number of studies on COVID-19 indicates that it will be necessary to conduct active research with the emergence of new variants of the diseases [70][71][72].…”

The COVID-19 Assessment for Survival at Admission (CASA) Index: A 12 Months Observational Study

“…In addition, another hematological aspect has emerged in our analysis. While lymphopenia has been invariably linked to the disease itself irrespective of the severity status, leucocytosis is common in patients with aggressive evolution ( 47 ), thus adding the disruption of the immune system associated with possible bacterial infection as an additional mortality risk factor, and supporting the relevance of a dynamic monitoring for the early identification of white blood cell increase ( 48 ).…”