Article ; Online: Value of leukocytosis and elevated C-reactive protein in predicting severe coronavirus 2019 (COVID-19): A systematic review and meta-analysis.
Clinica chimica acta; international journal of clinical chemistry
2020 Volume 509, Page(s) 235–243
Abstract: ... In patients with COVID-19, fever, leukocytosis, and an elevated CRP were associated with severe outcomes ... the association between severe COVID-19 and a change in white blood cell (WBC) count, an elevation of C-reactive ... Background: Since December 2019, coronavirus 2019 (COVID-19) has spread worldwide. Identifying ...
| Abstract | Background: Since December 2019, coronavirus 2019 (COVID-19) has spread worldwide. Identifying poor prognostic factors is helpful for risk stratification. In this meta-analysis, we investigated the association between severe COVID-19 and a change in white blood cell (WBC) count, an elevation of C-reactive protein (CRP), and fever. Moreover, we aimed to evaluate the diagnostic accuracy of leukocytosis and an elevation of CRP. Methods: We performed a systematic search of PubMed, EMBASE, Scopus, and the Cochrane Library through April 20th, 2020. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A sensitivity analysis was conducted according to the study size (>200 or <200) and median age (>55 or <55). Meta-regression analyses were conducted to examine possible sources of heterogeneity. We calculated the diagnostic accuracy of leukocytosis and CRP. Results: Eighteen studies with 3278 patients were selected. Fever, leukocytosis, and elevated CRP were associated with poor outcomes (OR (95% CI) 1.63 (1.06-2.51), 4.51 (2.53-8.04), and 11.97 (4.97-28.8), respectively). Leukopenia was associated with a better prognosis (OR 0.56, 95% CI 0.40-0.78). Sensitivity analyses showed similar tendencies. Meta-regression analysis for leukocytosis indicated that age, dyspnea, and hypertension contributed to heterogeneity. The pooled area under the leukocytosis and CRP curves were 0.70 (0.64-0.76) and 0.89 (0.80-0.99), respectively. Conclusion: In patients with COVID-19, fever, leukocytosis, and an elevated CRP were associated with severe outcomes. Leukocytosis and CRP on arrival may predict poor outcomes. |
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| MeSH term(s) | Betacoronavirus ; Biomarkers/blood ; C-Reactive Protein/metabolism ; COVID-19 ; Coronavirus Infections/blood ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Humans ; Leukocytosis/blood ; Leukocytosis/diagnosis ; Leukocytosis/epidemiology ; Leukopenia/blood ; Leukopenia/diagnosis ; Leukopenia/epidemiology ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Prognosis ; Retrospective Studies ; SARS-CoV-2 |
| Chemical Substances | Biomarkers ; C-Reactive Protein (9007-41-4) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-06-10 |
| Publishing country | Netherlands |
| Document type | Journal Article ; Meta-Analysis ; Systematic Review |
| ZDB-ID | 80228-1 |
| ISSN | 1873-3492 ; 0009-8981 |
| ISSN (online) | 1873-3492 |
| ISSN | 0009-8981 |
| DOI | 10.1016/j.cca.2020.06.008 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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