Vol 5, No 4 (2020)
Research paper
Published online: 2020-10-28

open access

Page views 872
Article views/downloads 753
Get Citation

Connect on Social Media

Connect on Social Media

Can hematological and biochemical parameters fasten the diagnosis of COVID-19 in emergency departments?

Burak Katipoğlu1, Leyla Öztürk Sönmez2, Hülya Vatansev3, Nalan Yüce1, Mustafa Sabak4, Lukasz Szarpak567, Togay Evrin1
Disaster Emerg Med J 2020;5(4):175-181.

Abstract

INTRODUCTION: The primary aim of the study was to compare the laboratory and radiological parameters of COVID-19 positive and negative patients confirmed by Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), and Chest Computed Tomography (CCT) of patients admitting with the suspicion of COVID-19. The secondary purpose of the study was to find objective parameters to speed up the clinician for further examination, treatment or referral decision in COVID-19 suspicion.

MATERIAL AND METHODS: A total of 61 COVID-19 suspected patients were evaluated in the study. Swab samples were taken for RT-PCR analysis. CCT was taken for 42 patients who described dyspnea. According to CCT and RT-PCR results, the patient population was divided into 2 groups as COVID-19 positive group (n = 32); and COVID-19 negative group (n = 29). Between two groups; demographic, clinical, laboratory and radiological parameters were compared.

RESULTS: Male gender (p = 0.03), PLR value (p = 0.021) and CO-RADS scores were higher in the COVID-19 positive group. Oxygen saturation (SaO2) (p = 0.027) and PCT, WBC, Neutrophil count, Lymphocyte count values were significantly low in COVID-19 positive group (p = 0.03, p = 0.001, p = 0.017, p = 0.021, respectively). PLR showed a positive correlation with fever, CRP, neutrophil count and NLR, which are indicators of inflammation.

CONCLUSIONS: SaO2, WBC, lymphocyte count, neutrophil count and low PCT levels, and PLR elevation showed a significant difference in COVID-19 patients in our retrospective cohort study examining the Turkish population. We believe that these results will allow clinicians to make quick decisions in patient management more simply.

Article available in PDF format

View PDF Download PDF file

References

  1. Ge H, Wang X, Yuan X, et al. The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis. 2020; 39(6): 1011–1019.
  2. Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020; 92(4): 441–447.
  3. Guan WJ, Ni ZY, Hu Yu, et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 382(18): 1708–1720.
  4. Çınar E. Türkdoğan Pratik Acil Tıp, Section 10: Pneumonia, 1st Ed. (İstanbul: EMA Medicine Publisher. ; 2020: pp.
  5. Mehta P, McAuley DF, Brown M, et al. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 395(10229): 1033–1034.
  6. Bangash MN, Patel J, Parekh D. COVID-19 and the liver: little cause for concern. Lancet Gastroenterol Hepatol. 2020; 5(6): 529–530.
  7. Kermali M, Khalsa RK, Pillai K, et al. The role of biomarkers in diagnosis of COVID-19 - A systematic review. Life Sci. 2020; 254: 117788.
  8. Turkish Health Ministry SARS Cov- 2 Infection Guide, English version avaible at: https://hsgm. saglik gov tr/depo/birimler/goc_sagligi/covid19/rehber/COVID-19_Rehberi20200414_eng_v4_002_14 05. ; 2020: pdf.
  9. Prokop M, van Everdingen W, van Rees Vellinga T, et al. COVID-19 Standardized Reporting Working Group of the Dutch Radiological Society. CO-RADS: A Categorical CT Assessment Scheme for Patients Suspected of Having COVID-19-Definition and Evaluation. Radiology. 2020; 296(2): E97–E9E104.
  10. Chan JFW, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020; 395(10223): 514–523.
  11. Zhao S, Lin Q, Ran J, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020; 92: 214–217.
  12. Bronchogenic cyst. Definitions. 2020.
  13. Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiology: Cardiothoracic Imaging. 2020.
  14. Fu J, Kong J, Wang W, et al. The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China. Thromb Res. 2020; 192: 3–8.
  15. Liu Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020; 81(1): e6–ee12.
  16. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10223): 497–506.
  17. Yang AP, Liu JP, Tao WQ, et al. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020; 84: 106504.
  18. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020; 95(7): 834–847.
  19. Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020; 12(1): 8.
  20. Chan JW, Zhang A, Yuan S, et al. Simulation of the Clinical and Pathological Manifestations of Coronavirus Disease 2019 (COVID-19) in a Golden Syrian Hamster Model: Implications for Disease Pathogenesis and Transmissibility. Clinical Infectious Diseases. 2020.
  21. Shi S, Qin Mu, Shen Bo, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020; 5(7): 802–810.
  22. Liu Y, Sun W, Guo Y, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets. 2020; 31(4): 490–496.
  23. Qu R, Ling Y, Zhang YH, et al. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020 [Epub ahead of print].
  24. Smereka J, Szarpak L, Filipiak K. Modern medicine in COVID-19 era. Disaster and Emergency Medicine Journal. 2020.



Disaster and Emergency Medicine Journal