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

Ramy Abou Ghayda, Jinhee Lee, Jun Young Lee, Da Kyung Kim, Keum Hwa Lee, Sung Hwi Hong, Young Joo Han, Jae Seok Kim, Jae Won Yang, Andreas Kronbichler, Lee Smith, Ai Koyanagi, Louis Jacob and Jae Il Shin
Additional contact information
Ramy Abou Ghayda: Division of Urology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
Jinhee Lee: Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
Jun Young Lee: Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
Da Kyung Kim: Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
Keum Hwa Lee: Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Korea
Sung Hwi Hong: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Young Joo Han: Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea
Jae Seok Kim: Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
Jae Won Yang: Department of Nephrology, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
Andreas Kronbichler: Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck 6020, Austria
Lee Smith: The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
Ai Koyanagi: Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain
Louis Jacob: Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 08830 Barcelona, Spain
Jae Il Shin: Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Korea

IJERPH, 2020, vol. 17, issue 14, 1-15

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.

Keywords: COVID-19; correlation; clinical characteristics; laboratory findings; treatment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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