Table 5. Frequency of laboratory findings, from the quality effects models, across all studies and in study subgroups.
| Overall | Initially asymptomatic | Early | Pregnant | All-comers | Admitted to hospital | Severely ill patients | Source of heterogeneity identified by meta-regression | |||
|---|---|---|---|---|---|---|---|---|---|---|
| All | Mild / moderate | Moderate / severe | ||||||||
| ALT—elevated | 0.00–0.41 (n = 1,966; 16 studies) Pooled 0.22; 95% CI 0.14–0.32 Q = 134.39; p<0.01; I2 = 89% |
0.00–0.08 (n = 79; 2 studies) Pooled 0.02; 95% CI 0.00–0.13 Q = 4.36; p = 0.04; I2 = 77% |
– | – | 0.21 (n = 741; 1 study) | 0.04–0.41 (n = 1146; 13 studies) Pooled 0.26; 95% CI 0.18–0.35 Q = 84.87; p<0.01; I2 = 86% |
0.04–0.28 (n = 263; 4 studies) Pooled 0.11; 95% CI 0.03–0.22 Q = 12.22; p = 0.01; I2 = 75% |
0.17–0.41 (n = 883; 9 studies) Pooled 0.31; 95% CI 0.25–0.38 Q = 23.16; p<0.01; I2 = 65% |
0.28–0.41 (n = 388; 3 studies): (n = 135; 1 all-comers study) 0.28 (n = 49; 2 moderate/severe studies) Pooled 0.40; 95% CI 0.34–0.46 Q = 0.01; p = 0.93; I2 = 0% |
All hospitalized patients: More moderate/severe patients present with elevated ALT than mild/moderate 0.31 (95% CI 0.25–0.38) vs. 0.11 (95% CI 0.02–0.22) Increasing prevalence with increasing severity R2 = 52%; p = 0.006 |
| AST—elevated | 0.00–0.61 (n = 2,026; 17 studies) Pooled 0.26; 95% CI 0.17–0.36 Q = 97.70; p<0.01; I2 = 87% |
0.00 (n = 24; 1 study) | – | – | 0.10–0.22 (n = 848; 2 studies) Pooled 0.21; 95% CI 0.06–0.39 Q = 8.78; p<0.01; I2 = 89% |
0.16–0.61 (n = 1154; 14 studies) Pooled 0.26; 95% CI 0.17–0.36 Q = 44.69; p<0.01; I2 = 78% |
0.16–0.25 (n = 325; 5 studies) Pooled 0.14; 95% CI 0.06–0.25 Q = 16.25; p<0.01; I2 = 75% |
0.17–0.61 (n = 829; 9 studies) Pooled 0.33; 95% CI 0.25–0.42 Q = 36.24; p<0.01; I2 = 78% |
0.33–0.62 (n = 454; 6 studies) Pooled 0.42; 95% CI 0.34–0.51 Q = 10.74; p = 0.06; I2 = 53% |
All hospitalized patients: More moderate/severe patients present with elevated AST than mild/moderate 0.33 (95% CI 0.25–0.42) vs. 0.14 (95% CI 0.06–0.25) Increasing prevalence with increasing severity R2 = 59%; p = 0.001 |
| CRP—elevated | 0.17–1.00 (n = 2,305; 26 studies) | 0.17–0.18 (n = 78; 2 studies) Pooled 0.19; 95% CI 0.10–0.28 Q = 0.0; p>0.99; I2 = 0% |
0.30–0.99 (n = 118; 2 studies) | 0.41–0.81 (n = 48; 3 studies) Pooled 0.59; 95% CI 0.34–0.82 Q = 5.52; p = 0.06; I2 = 64% |
0.54–0.61 (n = 884; 2 studies) Pooled 0.60; 95% CI 0.54–0.66 Q = 1.57; p = 0.21; I2 = 36% |
0.38–1.00 (n = 1177; 17 studies) | 0.38–1.00 (n = 559; 10 studies) Pooled 0.63; 95% CI 0.48–0.77 Q = 93.14; p<0.01; I2 = 89.9% |
0.60–0.92 (n = 618; 7 studies) Pooled 0.80; 95% CI 0.68–0.91 Q = 58.74; p<0.01; I2 = 89.8% |
0.40.–1.00 (n = 320; 7 studies) Pooled 0.88; 95% CI 0.76–0.98 Q = 26.26; p<0.01; I2 = 77% |
All hospitalized patients: More severely ill patients present with elevated CRP than mild/moderate 0.88 (95% CI 0.76–0.98) vs. 0.63 (95% CI 0.48–0.77) Moderate/severe patients: Increasing prevalence with increasing severity R2 = 95%; p<0.001 (excluding Zhang J et al. 2020 [45] based on sensitivity analysis) |
| D-dimer—elevated | 0.04–0.46 (n = 1,657; 12 studies) | 0.18 (n = 22; 1 study) | – | – | 0.08–0.46 (n = 651; 2 studies) | 0.04–0.43 (n = 985; 9 studies) | 0.04–0.14 (n = 261; 3 studies) Pooled 0.09; 95% CI 0.03–0.18 Q = 6.74; p = 0.03; I2 = 70% |
0.14–0.43 (n = 724; 6 studies) Pooled 0.29; 95% CI 0.18–0.42 Q = 48.60; p<0.01; I2 = 89.7% |
0.14–0.61 (n = 296; 3 studies) (n = 147; 2 studies) Pooled 0.60; 95% CI 0.52–0.68 Q = 0.0006; p = 0.94; I2 = 0% 0.14 (n = 149; one study with the most severely ill patients that was excluded from meta-regression of all hospitalized studies) |
All hospitalized patients: More moderate/severe patients present with elevated D-dimer than mild/moderate 0.29 (95% CI 0.18–0.42) vs. 0.09 (95% CI 0.03–0.18) Increasing prevalence with increasing severity R2 = 67%; p = 0.009 (excluding two studies with the most severe patients Wu, C [46] and Yang, X. [47]) |
| ESR—elevated | 0.09–0.92 (n = 647; 9 studies) | 0.36 (n = 55; 1 study) | – | – | – | 0.09–0.92 (n = 592; 8 studies) | 0.09–0.74 (n = 219; 4 studies) | 0.59–0.92 (n = 373; 4 studies) Pooled 0.87; 95% CI 0.75–0.95 Q = 16.44; p<0.01; I2 = 82% |
0.81 (n = 199; 1 study) |
All hospitalized patients: Increasing prevalence with increasing severity R2 = 49%; p = 0.079 (excluding Zhao, X. et al. 2020 [48]) |
| IL-6—elevated | 0.00–0.94 (n = 480; 6 studies) | 0.00 (n = 55; 1 study) | – | – | – | 0.27–0.94 (n = 425; 5 studies) | 0.27 (n = 26; 1 study) | 0.38–0.94 (n = 399; 4 studies) | 0.76–0.94 (n = 75; 2 studies) Pooled 0.91; 95% CI 0.69–1.00 Q = 4.46; p = 0.03; I2 = 78% |
All hospitalized patients: Increasing prevalence with increasing severity R2 = 70%; p = 0.086* |
| Lymphocytes—low | 0.17–0.89 (n = 2,926; 30 studies) | 0.17–0.20 (n = 79; 2 studies) Pooled 0.20; 95% CI 0.11–0.29 Q = 0.08; p = 0.79; I2 = 0% |
0.20–0.60 (n = 118; 2 studies) Pooled 0.50; 95% CI 0.09–0.91 Q = 5.89; p = 0.02; I2 = 83% |
0.29–0.80 (n = 48; 3 studies) Pooled 0.54; 95% CI 0.24–0.84 Q = 8.24; p = 0.02; I2 = 76% |
0.83 (n = 879; 1 study) | 0.28–0.89 (n = 1802; 22 studies) | 0.28–0.84 (n = 753; 11 studies) | 0.35–0.89 (n = 1049; 11 studies) | 0.80–0.89 (n = 175; 4 studies) Pooled 0.84; 95% CI 0.77–0.89 Q = 1.9; p = 0.60; I2 = 0% |
Mild/moderate and Moderate/severe: Increasing prevalence with increasing severity Mild/moderate more severe patients: R2 = 78; p = 0.026 (6 studies) Moderate/severe more severe patients: R2 = 67%; p = 0.030 (7 studies) |
| Lymphocytes—elevated | 0.00–0.50 (n = 506; 6 studies) | – | 0.40 (n = 108; 1 study | 0.00 (n = 15; 1 study) | – | 0.00–0.50 (n = 383; 4 studies) | – | 0.00–0.50 (n = 383; 4 studies) | – |
Moderate/severe: Decreasing prevalence with increasing severity R2 = 81%; p = 0.098* |
| Neutrophils—low | 0.00–0.23 (n = 636; 8 studies) Pooled 0.06; 95% CI 0.01–0.29 Q = 22.77; p<0.01; I2 = 69% |
0.20 (n = 55; 1 study) | – | – | 0.11 (n = 91; 1 study) | 0.00–0.23 (n = 490; 6 studies) | 0.00–0.23 (n = 229; 2 studies) | 0.00–0.03 (n = 261; 4 studies) Pooled 0.02; 95% CI 0.00–0.05 Q = 8.33; p = 0.04; I2 = 64% |
0.08 (n = 25; 1 study) | - |
| Neutrophils—elevated | 0.03–0.61 (n = 811; 11 studies) | – | – | – | 0.03 (n = 91; 1 study) | 0.04–0.61 (n = 720; 10 studies) | 0.04–0.61 (n = 295; 5 studies) | 0.12–0.38 (n = 425; 5 studies) Pooled 0.30; 95% CI 0.20–0.42 Q = 15.93; p<0.01; I2 = 75% |
0.28 (n = 83; 1 study) | – |
| PCT—elevated | 0.00–0.53 (n = 947; 13 studies) | 0.21(n = 24; 1 study) | – | – | 0.15 (n = 91; 1 study) | 0.00–0.53 (n = 832; 11 studies) | 0.00–0.25 (n = 190; 4 studies) Pooled 0.05; 95% CI 0.00–0.15 Q = 15.63; p<0.01; I2 = 81% |
0.01–0.53 (n = 642; 7 studies) | 0.10–0.50 (n = 226; 5 studies) Pooled 0.22; 95% CI 0.07–0.40 Q = 26.62.; p<0.01; I2 = 85% |
– |
| Platelets—low | 0.05–0.36 (n = 1,829; 12 studies) | – | – | – | 0.11–0.36 (n = 960; 2 studies) | 0.05–0.26 (n = 869; 10 studies) Pooled 0.12; 95% CI 0.09–0.16 Q = 20.86; p = 0.01; I2 = 57% |
0.05–0.14 (n = 291; 3 studies) Pooled 0.12; 95% CI 0.07–0.18; Q = 4.09; p = 0.13; I2 = 51% |
0.07–0.26 (n = 578; 7 studies) Pooled 0.12; 95% CI 0.07–0.18; Q = 16.49; p = 0.01; I2 = 64% |
– |
Moderate/severe patients: Decreasing prevalence with increasing severity R2 = 61%; p = 0.016 |
| Platelets—elevated | 0.00–0.05 (n = 498; 6 studies) | – | – | – | 0.03 (n = 91; 1 study) | 0.00–0.05 (n = 407; 5 studies) Pooled 0.02; 95% CI 0.00–0.06 Q = 11.13; p = 0.03; I2 = 64% |
0.00–0.05 (n = 229; 2 studies) Pooled 0.03; 95% CI 0.00–0.10 Q = 7.13; p = 0.01; I2 = 86% |
0.00–0.04 (n = 178; 3 studies) Pooled 0.03; 95% CI 0.00–0.07 Q = 3.75; p = 0.15; I2 = 47% |
– | – |
| Troponin | 0.07–0.17 (n = 181; 3 studies) | – | – | – | – | Only data on moderate/severe patients were available | – | 0.07–0.17 (n = 181; 3 studies) Pooled 0.16; 95% CI 0.11–0.22 Q = 0.74; p = 0.69; I2 = 0% |
– | – |
| WBC—low | 0.00–0.51 (n = 3,364; 29 studies) | 0.17–0.20 (n = 79; 2 studies) Pooled 0.19; 95% CI 0.11–0.29 Q = 0.07; p = 0.79; I2 = 0% |
0.10–0.33 (n = 169; 3 studies) Pooled 0.18; 95% CI 0.03–0.39 Q = 11.80; p<0.01; I2 = 83% |
– | 0.15–0.34 (n = 1204; 3 studies) Pooled 0.31; 95% CI 0.16–0.48 Q = 18.29; p = <0.01; I2 = 89% |
0.00–0.51 (n = 1912; 21 studies) | 0.00–0.51 (n = 777; 10 studies) | 0.00–0.37 (n = 1135; 11 studies) Pooled 0.18; 95% CI 0.12–0.24 Q = 55.96; p<0.01; I2 = 82% |
0.08–0.16 (n = 308; 4 studies) Pooled 0.11; 95% CI 0.08–0.15 Q = 1.6; p = 0.659; I2 = 0% |
All hospitalized and moderate/severe patients: Decreasing prevalence with increasing severity All hospitalized: R2 = 32%; p = 0.012 (excluding Bai H et al. 2020 [49]) Moderate/severe: R2 = 18%; p = 0.043 |
| WBC—elevated | 0.00–0.50 (n = 3,341; 26 studies) | 0.02 (n = 55; 1 study) | 0.00 (n = 108; 1 study) | 0.50 (n = 16; 1 study) | 0.03–0.06 (n = 1069; 2 studies) Pooled 0.06; 95% CI 0.04–0.07 Q = 0.88; p = 0.35; I2 = 0% |
0.00–0.35 (n = 2093; 21 studies) | 0.00–0.29 (n = 747; 9 studies) Pooled 0.03; 95% CI 0.02–0.05 Q = 6.08; p = 0.53; I2 = 0% (excluding Bai H et al. 2020 [49]) |
0.03–0.35 (n = 1346; 12 studies) Pooled 0.17; 95% CI 0.12–0.23 Q = 55.03; p<0.01; I2 = 80% |
0.08–0.54 (n = 362; 5 studies) Pooled 0.21; 95% CI 0.10–0.35 Q = 17.87; p<0.01; I2 = 78% |
All hospitalized patients: More moderate/severe patients present with elevated WBC than mild/moderate 0.17 (95% CI 0.12–0.23) vs. 0.03 (95% CI 0.02–0.05) Moderate/severe: Increasing prevalence with increasing severity R2 = 61%; p = 0.002 (excluding Bai H et al. 2020 [49]) |
ALT, alanine aminotransferase; AST, aspartate aminotransferase; CI, confidence interval; CRP, C-reactive protein; PCT, procalcitonin; IL-6, interleukin-6; WBC, white blood cell count.
Pooled prevalence estimates and 95% CIs are shown where there was appropriately low heterogeneity (I2<90%).
*significance at 0.1 level.