A systematic review of clinical and laboratory parameters associated with increased severity among COVID-19 patients
- PMID: 33711574
- PMCID: PMC7896120
- DOI: 10.1016/j.dsx.2021.02.020
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 × 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; Clinical symptoms; Laboratory parameters; Systematic review.
Copyright © 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.
Conflict of interest statement
Declaration of competing interest There is no conflict of interest.
Figures





Similar articles
-
Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia.Am J Infect Control. 2021 Jan;49(1):82-89. doi: 10.1016/j.ajic.2020.06.008. Epub 2020 Jun 12. Am J Infect Control. 2021. PMID: 32540370 Free PMC article. Review.
-
Risk factors of severe cases with COVID-19: a meta-analysis.Epidemiol Infect. 2020 Aug 12;148:e175. doi: 10.1017/S095026882000179X. Epidemiol Infect. 2020. PMID: 32782035 Free PMC article.
-
Clinical characteristics of Egyptian male patients with COVID-19 acute respiratory distress syndrome.PLoS One. 2021 Apr 16;16(4):e0249346. doi: 10.1371/journal.pone.0249346. eCollection 2021. PLoS One. 2021. PMID: 33861750 Free PMC article.
-
Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis.Am J Emerg Med. 2021 Mar;41:110-119. doi: 10.1016/j.ajem.2020.12.076. Epub 2020 Dec 30. Am J Emerg Med. 2021. PMID: 33418211 Free PMC article.
-
Cytokine storm in severe COVID-19 pneumonia.J Med Virol. 2021 Sep;93(9):5474-5480. doi: 10.1002/jmv.27068. Epub 2021 May 15. J Med Virol. 2021. PMID: 33963559 Free PMC article.
Cited by
-
Novel COVID-19 biomarkers identified through multi-omics data analysis: N-acetyl-4-O-acetylneuraminic acid, N-acetyl-L-alanine, N-acetyltriptophan, palmitoylcarnitine, and glycerol 1-myristate.Intern Emerg Med. 2024 Aug;19(5):1439-1458. doi: 10.1007/s11739-024-03547-1. Epub 2024 Feb 28. Intern Emerg Med. 2024. PMID: 38416303
-
The impact of COVID on bacterial sepsis.Eur J Clin Microbiol Infect Dis. 2023 Oct;42(10):1173-1181. doi: 10.1007/s10096-023-04655-0. Epub 2023 Aug 19. Eur J Clin Microbiol Infect Dis. 2023. PMID: 37597051
-
Temporal trends in the incidence and case severity of COVID-19 cases among the Syrian refugees in Azraq camp in Jordan: A retrospective observational study.PLoS Negl Trop Dis. 2025 Feb 19;19(2):e0012875. doi: 10.1371/journal.pntd.0012875. eCollection 2025 Feb. PLoS Negl Trop Dis. 2025. PMID: 39970190 Free PMC article.
-
Validation of MuLBSTA score to derive modified MuLB score as mortality risk prediction in COVID-19 infection.PLOS Glob Public Health. 2022 Aug 1;2(8):e0000511. doi: 10.1371/journal.pgph.0000511. eCollection 2022. PLOS Glob Public Health. 2022. PMID: 36962449 Free PMC article.
-
Determining population-specific risk factors for COVID-19 susceptibility and severity to inform future individual-level integrated risk scoring.BMC Infect Dis. 2025 Aug 4;25(1):977. doi: 10.1186/s12879-025-11357-9. BMC Infect Dis. 2025. PMID: 40760409 Free PMC article.
References
-
- World Health Organization Coronavirus disease 2019 (COVID-19) situation report-72. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... Published April 1st , 2020.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials