Despite the growing knowledge of the clinicopathological features of COVID-19, the correlation between early changes in the laboratory parameters and the clinical outcomes of patients is not entirely understood. In this study, we aimed to assess the prognostic value of early laboratory parameters in COVID-19. We conducted a systematic review and meta-analysis based on the available literature in five databases. The last search was on July 26, 2020, with key terms related to COVID-19. Eligible studies contained original data of at least ten infected patients and reported on baseline laboratory parameters of patients. We calculated weighted mean differences (WMDs) for continuous outcomes and odds ratios (ORs) with 95% confidence intervals. 93 and 78 studies were included in quantitative and qualitative syntheses, respectively. Higher baseline total white blood cell count (WBC), C-reactive protein (CRP), lactate-dehydrogenase (LDH), creatine kinase (CK), D-dimer and lower absolute lymphocyte count (ALC) (WMD_ALC = − 0.35 × 10⁹/L [CI − 0.43, − 0.27], p < 0.001, I² = 94.2%; < 0.8 × 10⁹/L, OR_ALC = 3.74 [CI 1.77, 7.92], p = 0.001, I² = 65.5%) were all associated with higher mortality rate. On admission WBC, ALC, D-dimer, CRP, LDH, and CK changes could serve as alarming prognostic factors. The correct interpretation of laboratory abnormalities can guide therapeutic decisions, especially in early identification of potentially critical cases. This meta-analysis should help to allocate resources and save lives by enabling timely intervention.

尽管人们对 COVID-19 的临床病理学特征的了解越来越多，但实验室参数的早期变化与患者临床结果之间的相关性尚不完全清楚。在本研究中，我们旨在评估 COVID-19 早期实验室参数的预后价值。我们根据五个数据库中的现有文献进行了系统回顾和荟萃分析。上次搜索时间为 2020 年 7 月 26 日，关键词与 COVID-19 相关。符合条件的研究包含至少十名感染患者的原始数据，并报告了患者的基线实验室参数。我们计算了连续结果的加权平均差 (WMD) 和比值比 (OR)，置信区间为 95%。定量和定性综合中分别纳入了 93 项和 78 项研究。基线总白细胞计数 (WBC)、C 反应蛋白 (CRP)、乳酸脱氢酶 (LDH)、肌酸激酶 (CK)、D-二聚体较高，绝对淋巴细胞计数 (ALC) 较低 (WMD ALC = − _0.35  × 10 ⁹ /L [CI − 0.43, − 0.27]，p  < 0.001，I ²  = 94.2%；< 0.8 × 10 ⁹ /L，或_ALC  = 3.74 [CI 1.77, 7.92]，p  = 0.001，I ²  = 65.5 %）都与较高的死亡率相关。入院时 WBC、ALC、D-二聚体、CRP、LDH 和 CK 的变化可能是令人震惊的预后因素。对实验室异常的正确解释可以指导治疗决策，特别是在早期识别潜在危重病例时。这种荟萃分析应有助于通过及时干预来分配资源并挽救生命。