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

https://doi.org/10.1016/j.dsx.2021.02.020Get rights and content

Highlights

  • Severe COVID-19 cases occurred mostly in people with co-morbid conditions like hypertension, cancer and diabetes.

  • The laboratory parameters associated with severe disease were lymphopenia, and elevated LDH, D dimer and Procalcitonin >0.5

  • Use of mechanical ventilation did not improve the outcome of 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 × 109/L, thrombocytopenia 100 × 109/L, leucocytosis TC > 11 × 109/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.

Keywords

COVID-19
Systematic review
Clinical symptoms
Laboratory parameters

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