Thrombocytopenia as a prognostic marker in COVID-19 patients: diagnostic test accuracy meta-analysis
| Autor: | Idrus Alwi, Ian Huang, Emir Yonas, Raymond Pranata, Michael Anthonius Lim, Sally Aman Nasution, Siti Setiati, Raden Ayu Tuty Kuswardhani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology Subgroup analysis 030204 cardiovascular system & hematology Likelihood ratios in diagnostic testing Gastroenterology Sensitivity and Specificity Severity of Illness Index law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Severity of illness medicine Odds Ratio Humans 030212 general & internal medicine Aged platelet Original Paper business.industry Diagnostic Tests Routine SARS-CoV-2 Incidence (epidemiology) severe COVID-19 Odds ratio Nomogram Middle Aged Prognosis Intensive care unit mortality Respiration Artificial Thrombocytopenia Coronavirus thrombocyte Intensive Care Units Infectious Diseases Diagnostic odds ratio Female business |
| Zdroj: | Epidemiology and Infection |
| ISSN: | 1469-4409 0950-2688 |
| Popis: | This systematic review and meta-analysis aimed to evaluate thrombocytopenia as a prognostic biomarker in patients with coronavirus disease 2019 (COVID-19). We performed a systematic literature search using PubMed, Embase and EuropePMC. The main outcome was composite poor outcome, a composite of mortality, severity, need for intensive care unit care and invasive mechanical ventilation. There were 8963 patients from 23 studies. Thrombocytopenia occurred in 18% of the patients. Male gender (P = 0.037) significantly reduce the incidence. Thrombocytopenia was associated with composite poor outcome (RR 1.90 (1.43–2.52), P < 0.001; I2: 92.3%). Subgroup analysis showed that thrombocytopenia was associated with mortality (RR 2.34 (1.23–4.45), P < 0.001; I2: 96.8%) and severity (RR 1.61 (1.33–1.96), P < 0.001; I2: 62.4%). Subgroup analysis for cut-off 9/l showed RR of 1.93 (1.37–2.72), P < 0.001; I2: 83.2%). Thrombocytopenia had a sensitivity of 0.26 (0.18–0.36), specificity of 0.89 (0.84–0.92), positive likelihood ratio of 2.3 (1.6–3.2), negative likelihood ratio of 0.83 (0.75–0.93), diagnostic odds ratio of 3 (2, 4) and area under curve of 0.70 (0.66–0.74) for composite poor outcome. Meta-regression analysis showed that the association between thrombocytopenia and poor outcome did not vary significantly with age, male, lymphocyte, d-dimer, hypertension, diabetes and CKD. Fagan's nomogram showed that the posterior probability of poor outcome was 50% in patients with thrombocytopenia, and 26% in those without thrombocytopenia. The Deek's funnel plot was relatively symmetrical and the quantitative asymmetry test was non-significant (P = 0.14). This study indicates that thrombocytopenia was associated with poor outcome in patients with COVID-19. PROSPERO ID: CRD42020213974 |
| Databáze: | OpenAIRE |
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