Hematological Changes in Patients with Severe COVID-19: Systematic Review and Meta-Analysis
Larissa Gama Costa
Department of Life Sciences, State University of Bahia, Brazil.
Marinho Marques da Silva Neto *
Department of Life Sciences, State University of Bahia, Brazil.
Pedro Igor de Moura Souza
Department of Life Sciences, State University of Bahia, Brazil.
Marcos Pereira
Institute of Collective Health, Federal University of Bahia, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To produce a systematic review with meta-analysis on the hematological manifestations of COVID-19, comparing the changes among the clinical severity groups.
Study Design: We conducted a systematic review with meta-analyses.
Methodology: A systematic review was carried out based on the PRISMA 2020 protocol in Medline/Pubmed, Embase, LILACS and SciElo databases. A standardized mean difference was calculated to assess the differences between the groups, with a confidence interval of 95%. Heterogeneity was calculated using the Chi-square test and the I2 test. Significant heterogeneity was defined as p<0.10 or I2>50%.
Results: The systematic review search identified a total of 2682 articles, and at the end of the screening, 55 were selected for review and 16 for meta-analysis. The selected articles enrolled 13,289 participants, 10,312 with a mild to moderate clinical condition and 3977 with a severe to critical clinical condition. When comparing the severe disease group with the mild disease group, it was found that the mean values of leukocytes, neutrophils, C-reactive protein (CRP), ferritin, fibrinogen, and prothrombin time (PT) were significantly higher, and the lymphocyte count was significantly lower in the severe group.
Conclusions: Individuals with severe COVID-19 had reduced lymphocyte count and elevated leukocytes, neutrophils, CRP, ferritin, fibrinogen, and PT.
Keywords: COVID-19, SARS-CoV-2, hematological tests