Role of time-normalized laboratory findings in predicting COVID-19 outcome

Diagnosis ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 387-394
Author(s):  
Davide Ferrari ◽  
Andrea Seveso ◽  
Eleonora Sabetta ◽  
Daniele Ceriotti ◽  
Anna Carobene ◽  
...  
Keyword(s):  
White Blood Cells ◽  
Critical Issue ◽  
Time Dependent ◽  
Prognostic Indicators ◽  
Prognostic Information ◽  
Laboratory Findings ◽  
Laboratory Parameters ◽  
Infected People ◽  
Reactive Protein ◽  
Hospitalization Period

AbstractObjectivesThe pandemic COVID-19 currently reached 213 countries worldwide with nearly 9 million infected people and more than 460,000 deaths. Although several Chinese studies, describing the laboratory findings characteristics of this illness have been reported, European data are still scarce. Furthermore, previous studies often analyzed the averaged laboratory findings collected during the entire hospitalization period, whereas monitoring their time-dependent variations should give more reliable prognostic information.MethodsWe analyzed the time-dependent variations of 14 laboratory parameters in two groups of COVID-19 patients with, respectively, a positive (40 patients) or a poor (42 patients) outcome, admitted to the San Raffaele Hospital (Milan, Italy). We focused mainly on laboratory parameters that are routinely tested, thus, prognostic information would be readily available even in low-resource settings.ResultsStatistically significant differences between the two groups were observed for most of the laboratory findings analyzed. We showed that some parameters can be considered as early prognostic indicators whereas others exhibit statistically significant differences only at a later stage of the disease. Among them, earliest indicators were: platelets, lymphocytes, lactate dehydrogenase, creatinine, alanine aminotransferase, C-reactive protein, white blood cells and neutrophils.ConclusionsThis longitudinal study represents, to the best of our knowledge, the first study describing the laboratory characteristics of Italian COVID-19 patients on a normalized time-scale. The time-dependent prognostic value of the laboratory parameters analyzed in this study can be used by clinicians for the effective treatment of the patients and for the proper management of intensive care beds, which becomes a critical issue during the pandemic peaks.

scholarly journals Routine blood tests as a potential diagnostic tool for COVID-19

2020 ◽  
Vol 58 (7) ◽  
pp. 1095-1099 ◽  
Author(s):  
Davide Ferrari ◽  
Andrea Motta ◽  
Marta Strollo ◽  
Giuseppe Banfi ◽  
Massimo Locatelli
Keyword(s):  
Blood Test ◽  
Hematological Parameters ◽  
False Negative ◽  
White Blood Cells ◽  
Turnaround Time ◽  
Test Analysis ◽  
Infected People ◽  
Reactive Protein ◽  
Routine Blood ◽  
Glutamyl Transpeptidase

AbstractObjectivesThe outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to date, the epidemic has gradually spread to 209 countries worldwide with more than 1.5 million infected people and 100,000 deaths. Amplification of viral RNA by rRT-PCR serves as the gold standard for confirmation of infection, yet it needs a long turnaround time (3–4 h to generate results) and shows false-negative rates as large as 15%–20%. In addition, the need of certified laboratories, expensive equipment and trained personnel led many countries to limit the rRT-PCR tests only to individuals with pronounced respiratory syndrome symptoms. Thus, there is a need for alternative, less expensive and more accessible tests.MethodsWe analyzed the plasma levels of white blood cells (WBCs), platelets, C-reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase and lactate dehydrogenase (LDH) of 207 patients who, after being admitted to the emergency room of the San Raffaele Hospital (Milan, Italy) with COVID-19 symptoms, were rRT-PCR tested. Of them, 105 tested positive, whereas 102 tested negative.ResultsStatistically significant differences were observed for WBC, CRP, AST, ALT and LDH. Empirical thresholds for AST and LDH allowed the identification of 70% of either COVID-19-positive or -negative patients on the basis of routine blood test results.ConclusionsCombining appropriate cutoffs for certain hematological parameters could help in identifying false-positive/negative rRT-PCR tests. Blood test analysis might be used as an alternative to rRT-PCR for identifying COVID-19-positive patients in those countries which suffer from a large shortage of rRT-PCR reagents and/or specialized laboratory.

scholarly journals Utility of procalcitonin, C-reactive protein and white blood cells alone and in combination for the prediction of clinical outcomes in community-acquired pneumonia

2015 ◽  
Vol 53 (4) ◽  
Author(s):  
Andriy Zhydkov ◽  
Mirjam Christ-Crain ◽  
Robert Thomann ◽  
Claus Hoess ◽  
Christoph Henzen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Blood Cells ◽  
White Blood Cells ◽  
Community Acquired Pneumonia ◽  
Adverse Clinical Outcome ◽  
C Reactive Protein ◽  
Prognostic Information ◽  
Reactive Protein

AbstractThe added value of biomarkers, such as procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC), as adjuncts to clinical risk scores for predicting the outcome of patients with community-acquired pneumonia (CAP) is in question. We investigated the prognostic accuracy of initial and follow-up levels of inflammatory biomarkers in predicting death and adverse clinical outcomes in a large and well-defined cohort of CAP patients.We measured PCT, CRP and WBC on days 1, 3, 5, and 7 and followed the patients over 30 days. We applied multivariate regression models and area under the curve (AUC) to investigate associations between these biomarkers, the clinical risk score CURB-65, and clinical outcomes [i.e., death and intensive care unit (ICU) admission].Of 925 patients with CAP, 50 patients died and 118 patients had an adverse clinical outcome. None of the initial biomarker levels significantly improved the CURB-65 score for mortality prediction. Follow-up biomarker levels showed significant independent association with mortality at days 3, 5, and 7 and with improvements in AUC. Initial PCT and CRP levels were independent prognostic predictors of adverse clinical outcome, and levels of all biomarkers during the course of disease provided additional prognostic information.This study provides robust insights into the added prognostic value of inflammatory markers in CAP. Procalcitonin, CRP, and to a lesser degree WBC provided some prognostic information on CAP outcomes, particularly when considering their kinetics at days 5 and 7 and when looking at adverse clinical outcomes instead of mortality alone.

scholarly journals C-reactive protein and Neutrophil-Lymphocyte Ratio as predictors of clinical severity of COVID-19

2021 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Stefan Pandilov ◽  
Suzana Klenkoski ◽  
Elena Jovanovska Janeva ◽  
Gazmend Mehmeti ◽  
Dragan Mijakoski ◽  
...  
Keyword(s):  
Clinical Manifestation ◽  
White Blood Cells ◽  
Clinical Severity ◽  
Bivariate Analysis ◽  
C Reactive Protein ◽  
Lethal Outcome ◽  
Laboratory Parameters ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Markers Of Inflammation

COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyte’s count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.

Cumulative C-Reactive Protein Levels and Progression of Malnutrition in Dialysis Patients: A Longitudinal Study

2021 ◽  
pp. 1-6
Author(s):  
Kazuaki Asai ◽  
Masanori Shibata ◽  
Isao Ito ◽  
Hisae Tawada ◽  
Shinkichi Taniguchi
Keyword(s):  
Risk Index ◽  
Mirror Image ◽  
Time Dependent ◽  
Nutritional Risk ◽  
C Reactive Protein ◽  
Dialysis Patients ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Nutritional Risk Index

<b><i>Background/Aims:</i></b> Malnutrition is a serious complication in dialysis patients that develops slowly but steadily. Cross-sectional studies may not adequately characterize this complication because not only the intensity but longitudinally cumulative effect should also be taken into consideration. Relationship between time-dependent changes in a nutritional marker, Geriatric Nutritional Risk Index (GNRI), and cumulative C-reactive protein (CRP) values was examined whether both intensity and duration of inflammation correlated with time-dependent progression and severity of malnutrition over 3 years, retrospectively. <b><i>Methods:</i></b> One hundred and sixty-four dialysis patients were examined over 3 years retrospectively. Based on analysis of clinical and laboratory findings over a period of 3 years, patients were divided into 2 groups: those with a &#x3e;3.0 decrease in GNRI after 3 years (<i>n</i> = 84) and those in whom GNRI was unchanged (<i>n</i> = 80). <b><i>Results:</i></b> When comparing the 2 groups at 3 years, the GNRI-decreased group had 12% lower serum albumin (<i>p</i> &#x3c; 0.001) and lower levels of creatinine (9%, <i>p</i> &#x3c; 0.001), BUN (6%, <i>p</i> &#x3c; 0.05), total cholesterol (6%, <i>p</i> &#x3c; 0.05), and low-density lipoprotein cholesterol (10%, <i>p</i> &#x3c; 0.01), which suggest onset of malnutrition. CRP levels, routinely measured twice a month in all patients, were summed to calculate the cumulative CRP. Cumulative CRP after 3 years was 57.6 ± 7.8 (mg/dL/3 years) in the GNRI-decreased group, which was significantly higher than that in the GNRI-unchanged group (38.6 ± 3.9; <i>p</i> &#x3c; 0.05). Over 3 years, the GNRI-decreased group showed a time-dependent increase in cumulative CRP alongside a time-dependent decrease in the GNRI, producing an obvious mirror image; however, such inverse correlation was absent in the GNRI-unchanged group. <b><i>Conclusion:</i></b> A long-term perspective is needed in the management of malnutrition in dialysis patients because this complication develops progressively and is often irreversible when diagnosed. Cumulative CRP values may be useful in evaluating the degree of the progression of malnutrition in following up individual patients longitudinally.

scholarly journals Tracking of The Most Significant Laboratory Parameters For The Identification of Covid-19: An Overview on The Different Blood Tests

2020 ◽  
pp. 112-118
Author(s):  
Seenaa Ali
Keyword(s):  
Laboratory Tests ◽  
Systemic Disease ◽  
Laboratory Data ◽  
Virus Transmission ◽  
Albumin Level ◽  
Laboratory Findings ◽  
Multiple Systems ◽  
Laboratory Parameters ◽  
Infected People ◽  
Novel Coronavirus

An outbreak of 2019 novel coronavirus disease (COVID-19) began in China during December 2019 which unexpectedly spread to other countries and caused high mortality all over the world. COVID-19 disease primarily manifests as a respiratory tract infection. However, emerging data indicate that it should be regarded as a systemic disease for affecting multiple systems such as cardiovascular, respiratory, gastrointestinal and immune system. There is an accelerated need for detecting the laboratory tests that can aid in identifying infected people and asymptomatic carriers to control the virus transmission process. Although the clinical manifestation of COVID-19 has been widely defined, an overview of the most significant laboratory findings in patients with COVID-19 infection is still limited. Elevation was the predominate result among most of the laboratory parameters while a few decreased in value. Laboratory data have shown that most patients had a decrease in lymphocyte count, Eosinophils count and albumin level. Also, laboratory data recorded an elevation in Leukocyte, ESR, PT, D-dimer, PCT, CRP, ALT, AST, Bilirubin, Creatinine, CK, LDH, Ferritin, Troponin, Myoglobin, IL-6, IL10 and TNF. In general, the parameters had more prominent laboratory abnormalities in severe cases than with non-severe cases. It is well known that laboratory tests results play an important role and can support the early diagnosis of many diseases. This study was carried out to review the abnormalities among the laboratory tests and track the parameters that showed a frequently significant result supporting the primary detection of SARS-COV-2 infection.

scholarly journals C-reactive protein as a prognostic indicator in COVID-19 patients

2021 ◽  
Author(s):  
Mahmoud Sadeghi Haddad Zavareh ◽  
Masomeh Bayani ◽  
Mehran Shokri ◽  
Soheil Ebrahimpour ◽  
Arefeh Babazadeh ◽  
...  
Keyword(s):  
Serum Levels ◽  
Prognostic Indicator ◽  
Demographic Characteristics ◽  
Prognostic Indicators ◽  
Independent Factor ◽  
C Reactive Protein ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Study Population ◽  
Potential Biomarkers

Abstract While some biomolecules have been explored to identify potential biomarkers for prognosis of the COVID-19 prognosis, there are no reliable prognostic indicators of disease progression and severity. We aimed to evaluate the ability of the C-reactive protein (CRP) to predict COVID-19 infection. This retrospective study was conducted on 429 patients diagnosed with COVID-19 between March 30, 2020, and April 30, 2020. The study population was divided into severe cases (n = 175) and nonsevere cases (n = 254). Data on demographic characteristics, clinical features, and laboratory findings on admission were collected. The proportion of patients with increased CRP levels was significantly higher in severe cases than in nonsevere patients. Analysis of ROC curve found that CRP could be used as an independent factor in predicting the severity of COVID-19 infection. Also, patients with CRP > 64.75 mg/L were more likely to have severe complications. The serum levels of CRP can predict the severity and progression of illness in patients with COVID-19.

scholarly journals The Efficacy of Convalescent Plasma Use in Critically Ill COVID-19 Patients

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 257
Author(s):  
Livius Tirnea ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Bianca Cerbu ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Therapeutic Option ◽  
White Blood Cells ◽  
The United States ◽  
Plasma Therapy ◽  
Reactive Protein ◽  
United States Food ◽  
States Food

Background and Objectives: On 24 March 2020, the United States Food and Drug Administration (FDA) announced the approval of convalescent plasma therapy for critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as an emergency investigational new drug. This pilot study from Romania aimed to determine if convalescent plasma transfusion can be beneficial in the treatment of selected critically ill patients diagnosed with a SARS-CoV-2 infection. Materials and Methods: Donor and receiver eligibility for critically ill coronavirus disease 2019 (COVID-19) patients was based on Romanian guidelines issued at the time of the study. Here, we describe the evolution of a total of five eligible patients diagnosed with COVID-19 who received convalescent plasma (CP) in Romania. Results: In spite of our efforts and convalescent plasma administration, three of the five patients did not survive, while the other two recovered completely. Over the course of our five-day laboratory record, the surviving patients had significantly lower values for C-reactive protein, interleukin-6, and white blood cells. Conclusions: This pilot study provides insufficient evidence to determine the efficacy of convalescent plasma use as a therapeutic option for critically ill COVID-19 patients.

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