The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

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Chest CT imaging of pediatric COVID-19 infection: a case report

10.21203/rs.3.rs-21613/v1 ◽

2020 ◽

Author(s):

Huayan Xu ◽

Keke Hou ◽

Na Zhang ◽

Ming Yang ◽

Yingkun Guo

Keyword(s):

Cell Count ◽

Laboratory Tests ◽

Pediatric Patients ◽

White Cell Count ◽

Chest Ct ◽

White Cell ◽

The Other ◽

Imaging Features ◽

Rt Pcr ◽

Small Nodule

Abstract Background: Coronavirus Disease 2019 (COVID-19) outbreak in Wuhan, China spreading rapidly worldwide. Over 100 countries have reported surpassing 100,000 laboratory-confirmed cases of COVID- 19, and in which 2.1% were under aged 19 years. However, little is known about the imaging features about pediatric COVID-19 patients. Herein, we report two cases about COVID-19 involving the clinical data as well as chest images.Case presentation: Two pediatric patients admitted to hospital because of high fever or dry cough. Both children had been recent exposure to the COVID-19 confirmed patients of their family members. Real-time polymerase chain reaction(RT-PCR) test of these two patients’ sputum were positive for SARS-CoV-2 nucleic acid, and diagnosed as COVID-19 infection. Laboratory tests indicate normal white cell count (5.02 x10^9/L) and neutrophils (40.8%) in one case, and slightly increased white cell count (11.86 x10^9/L) and normal neutrophils (16.1%)in the other one. CRP of both cases were within the normal range. Computed tomography (CT) was used to evaluate the novel coronavirus pneumonia (NCP) of these two pediatric patients. Small nodule was found in the upper right lobe of one case; and bilateral peripheral ground-glass opacities were observed in the other patient.Conclusion: In summary, clinical symptoms and signs, laboratory tests and chest CT images of pediatric patients were untypical. Epidemic exposure history and RT-PCR results still play an important role in the precise diagnosis of COVID-19 children.

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Challenging the use of the lymphocyte to white cell count ratio in the diagnosis of infectious mononucleosis by analysis of a large cohort of monospot test results

Clinical Otolaryngology ◽

10.1111/j.1749-4486.2010.02187.x ◽

2010 ◽

Vol 35 (5) ◽

pp. 397-401 ◽

Cited By ~ 13

Author(s):

P. Lennon ◽

J.P. O’ Neill ◽

J.E. Fenton ◽

T. O’ Dwyer

Keyword(s):

Cell Count ◽

Infectious Mononucleosis ◽

White Cell Count ◽

White Cell ◽

Large Cohort ◽

Test Results ◽

Count Ratio

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Artefactual elevation of the automated white cell count in the context of a bone marrow aspirate analysis

Clinical & Laboratory Haematology ◽

10.1046/j.1365-2257.2000.00258-2.x ◽

2000 ◽

Vol 22 (1) ◽

pp. 57-57 ◽

Cited By ~ 1

Author(s):

J. F Lesesve ◽

V Latger ◽

J. Buisine ◽

T. Lecompte

Keyword(s):

Bone Marrow ◽

Cell Count ◽

Bone Marrow Aspirate ◽

White Cell Count ◽

White Cell

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Leucocytes and Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1649100 ◽

1973 ◽

Vol 30 (01) ◽

pp. 036-046 ◽

Cited By ~ 1

Author(s):

D.C Banks ◽

J.R.A Mitchell

Keyword(s):

Cell Count ◽

White Cell Count ◽

Cell Loss ◽

White Cell ◽

Structural Resemblance ◽

The Masses

SummaryWhen heparinised blood is rotated in a glass flask at 37°C. the white cell count falls and it has been shown that this is due to the adherence and aggregation of polymorphonuclear white cells on the wall of the flask. The masses formed bear a close structural resemblance to thrombi and the mechanisms involved in white cell loss during rotation may therefore increase our knowledge of the thrombotic process.

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An Assessment of Red Cell Deformability Using a Simple Filtration Method

10.1055/s-0038-1665788 ◽

1979 ◽

Author(s):

M Drummond ◽

G Lowe ◽

J Belch ◽

C Forbes ◽

J Barbenel

Keyword(s):

Cell Count ◽

Shear Viscosity ◽

White Cell Count ◽

White Cell ◽

Red Cell ◽

Cell Deformability ◽

Red Cell Deformability ◽

Simple Method ◽

Filtration Method ◽

Significant Difference

We investigated the reproducibility and validity of a simple method of measuring red cell deformability (filtration of whole blood through 5 µ sieves) and its relationship to haematocrit, blood viscosity, fibrinogen, white cell count, sex and smoking. The mean coefficient of variation in normals was 3. 7%. Tanned red cells showed marked loss of deformability. Blood filtration rate correlated with haematocrit (r = 0. 99 on dilution of samples, r = 0. 7 in 120 normals and patients). After correction for haematocrit, deformability correlated with high shear viscosity, but not low shear viscosity, fibrinogen or white cell count. In 60 normals there was no significant difference between males and females, or smokers and non-smokers, but in 11 smokers there was an acute fall in deformability after smoking 3 cigarettes (p<0. 05). Reduced deformability was found in acute myocardial infarction (n = 15, p<0. 01) and chronic peripheral arterial disease (n = 15, p<0. 01). The technique is reproducible, detects rigid cells and appears useful in the study of vascular disease.

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