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10.1002/jmv.26411

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suck abstract from ncbi


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pmid32776551      J+Med+Virol 2021 ; 93 (2): 1078-1098
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  • Association between markers of immune response at hospital admission and COVID-19 disease severity and mortality: A meta-analysis and meta-regression #MMPMID32776551
  • Khinda J; Janjua NZ; Cheng S; van den Heuvel ER; Bhatti P; Darvishian M
  • J Med Virol 2021[Feb]; 93 (2): 1078-1098 PMID32776551show ga
  • BACKGROUND: To determine the utility of admission laboratory markers in the assessment and prognostication of coronavirus disease-2019 (COVID-19), a systematic review and meta-analysis were conducted on the association between admission laboratory values in hospitalized COVID-19 patients and subsequent disease severity and mortality. MATERIAL AND METHODS: Searches were conducted in MEDLINE, Pubmed, Embase, and the WHO Global Research Database from December 1,2019 to May 1, 2020 for relevant articles. A random effects meta-analysis was used to calculate the weighted mean difference (WMD) and 95% confidence interval (95% CI) for each of 27 laboratory markers. The impact of age and sex on WMDs was estimated using meta-regression techniques for 11 markers. RESULTS: In total, 64 studies met the inclusion criteria. The most marked WMDs were for neutrophils (ANC) at 3.82 x 10(9) /L (2.76, 4.87), lymphocytes (ALC) at -0.34 x 10(9) /L (-0.45, -0.23), interleukin-6 (IL-6) at 32.59 pg/mL (23.99, 41.19), ferritin at 814.14 ng/mL (551.48, 1076.81), C-reactive protein (CRP) at 66.11 mg/L (52.16, 80.06), D-dimer at 5.74 mg/L (3.91, 7.58), LDH at 232.41 U/L (178.31, 286.52), and high sensitivity troponin I at 90.47 pg/mL (47.79, 133.14) when comparing fatal to nonfatal cases. Similar trends were observed comparing severe to non-severe groups. There were no statistically significant associations between age or sex and WMD for any of the markers included in the meta-regression. CONCLUSION: The results highlight that hyper inflammation, blunted adaptive immune response, and intravascular coagulation play key roles in the pathogenesis of COVID-19. Markers of these processes are good candidates to identify patients for early intervention and, importantly, are likely reliable regardless of age or sex in adult patients.
  • |*Adaptive Immunity[MESH]
  • |*Inflammation[MESH]
  • |Biomarkers/blood[MESH]
  • |C-Reactive Protein/analysis[MESH]
  • |COVID-19/*immunology/*mortality/physiopathology[MESH]
  • |Female[MESH]
  • |Fibrin Fibrinogen Degradation Products/analysis[MESH]
  • |Hospitalization/*statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Lymphocytes[MESH]
  • |Male[MESH]
  • |Neutrophils[MESH]
  • |Regression Analysis[MESH]


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