Can hematological and biochemical parameters fasten the diagnosis of COVID-19 in emergency departments?
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.
Keywords: CBCCOVID-19CO-RADSPLRRT-PCR
References
- 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.
- 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.
- 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.
- Çınar E. Türkdoğan Pratik Acil Tıp, Section 10: Pneumonia, 1st Ed. (İstanbul: EMA Medicine Publisher. ; 2020: pp.
- 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.
- Bangash MN, Patel J, Parekh D. COVID-19 and the liver: little cause for concern. Lancet Gastroenterol Hepatol. 2020; 5(6): 529–530.
- 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.
- 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.
- 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.
- 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.
- 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.
- Bronchogenic cyst. Definitions. 2020.
- 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.
- 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.
- 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.
- 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.
- 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.
- Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020; 95(7): 834–847.
- 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.
- 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.
- 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.
- 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.
- 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].
- Smereka J, Szarpak L, Filipiak K. Modern medicine in COVID-19 era. Disaster and Emergency Medicine Journal. 2020.