新型冠状病毒肺炎患者实验室指标改变发生率的meta分析

Meta-analysis of Incidence of Laboratory Changes in Patients with COVID-19

关键词:  新型冠状病毒肺炎  实验室指标  meta分析

Key words:  COVID-19  laboratory indexes  meta analysis

摘要:

目的 通过分析新型冠状病毒肺炎患者包括白细胞计数等实验室指标改变的发生率情况，为该疾病的识别及诊治提供参考。方法 系统检索Pubmed数据库、Embase数据库、Cochrane图书馆及中国知网、万方和维普数据库国内外新型冠状病毒肺炎临床特征和流行病学特征的相关临床研究，采用Stata 12.0进行单样本率的meta分析。结果 共纳入15项回顾性研究。Meta分析研究结果发现，研究存在异质性，新型冠状病毒肺炎患者实验室指标发生改变，其中白细胞计数正常或减少发生率为90%[95%CI(87%~93%)]，C反应蛋白(C-reactive protein，CRP)升高发生率为61%[95%CI(50%~ 73%)]，淋巴细胞计数减少发生率为43%[95%CI(28%~59%)]，降钙素原(procalcitonin，PCT)升高发生率为13%[95%CI (8%~18%)]，红细胞沉降率(erythrocyte sedimenta rate，ESR)升高发生率为74%[95%CI(61%~87%)]。结论 新型冠状病毒肺炎患者发病时白细胞计数一般正常或减少，CRP和ESR可能升高。

Abstract:

OBJECTIVE To provide reference of the identification and diagnosis of coronavirus disease 2019(COVID-19) by analyzing the incidence of changes in laboratory indexes including leukocyte count in patients with COVID-19. METHODS Databases of Medline, Embase, Cochrane library, CNKI, Wangfang and VIP were searched for study of clinical features and epidemiological features of COVID-19, Stata 12.0 were performed to conduct single sample rate meta-analysis. RESULTS A total of 15 studies contributed to the meta-analysis, revealing a large degree of inconsistency among the trials:the incidence of normal or decreased white blood cell count was 90%[95%CI(87%-93%)], the incidence of C-reactive protein(CRP) elevation was 61%[95%CI(50%-73%)], the incidence of decreased lymphocyte count was 43%[95%CI(28%-59%)], the incidence of procalcitonin(PCT) elevation was 13%[95%CI(8%-18%)], and the incidence of erythrocyte sedimenta rate(ESR) elevation was 74%[95%CI(61%-87%)]. CONCLUSION The white blood cell count is usually normal or decreased, CRP and ESR may increase among patients with COVID-19.