Lymphocyte and Platelet Counts, as well as Interleukin-6 Levels, Predict Mortality of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

Abstract

Objective. To systematically evaluate the value of lymphocytes, platelets, and interleukin-6 in predicting the mortality of patients with coronavirus disease 2019 (COVID-19) and to provide medical evidence for the long-term prognosis of patients with COVID-19. Methods. The latest studies published until July 1, 2021, were retrieved from databases including PubMed, Embase, and Cochrane Library to analyze the ability of lymphocyte and platelet counts as well as interleukin-6 levels to predict mortality in patients with COVID-19. Two reviewers independently screened the literature and extracted data, then evaluated the risk of bias of included studies using the Newcastle–Ottawa Scale (NOS), and used Stata 15.0 software for meta-analysis. Results. A total of nine studies were included, involving 4340 patients. There were 1330 patients in the death group and 3010 patients in the survival group. Meta-analysis showed that, compared with the survival group, lymphocyte counts in the death group were significantly lower (SMD = −0.64, 95% CI: −0.86–−0.43, $p<0.01$ ), platelet counts were significantly lower (SMD = −0.47, 95% CI: −0.67–−0.27, $p<0.01$ ), and interleukin-6 levels were significantly higher (SMD = 1.07, 95% CI: 0.62–1.53, $p<0.01$ ). Conclusion. Lymphocyte and platelet counts, as well as interleukin-6 levels, can help predict the mortality of patients with COVID-19. Due to the limitation of the number and quality of the included studies, these conclusions need to be validated by additional high-quality studies.