Background: The coronavirus pandemic which had its origin in the Wuhan China has been spreading across the globe with far reaching complications and a variable clinical course. A variation of the ...laboratory parameters during the disease course remains a constant parameter to monitor the disease course and progression. Since the laboratory parameters are standardized globally, these may also act as uniform guidelines for the patients monitoring and treatment.
Aims and Objectives: The aim of the study was to serial charting of the laboratory parameters in the recovered and expired patients of COVID-19 and to determine an associated prognostic significance.
Materials and Methods: A retrospective observational study from the laboratory and medical records was conducted on the patients admitted from March 17, 2020, to May 31, 2020, at the tertiary care center dedicated to the treatment of RT-PCR confirmed COVID-19 positive patients.
Results: The group of parameters showing a poor prognosis include a rising WBC count, high neutrophilic percentage, low lymphocyte percentage (<10) an NLR > 15, low lymphocyte monocyte ratio < 3, rising blood urea nitrogen, serum creatinine levels, and serum electrolyte levels. The liver function tests variation reflecting a poor metabolic activity of the liver, namely, a low serum albumin and albumin globulin ratio, rising SGOT levels, and total bilirubin levels. A highly significant variation in the acute phase reactants showing an exponential rise such as the serum lactate dehydrogenase levels, serum ferritin, fibrinogen, C-reactive protein, and IL 6 levels an increased level of D Dimer (>3) and a prolongation of the APTT.
Conclusion: The variation of the laboratory parameters acts as a fair marker for the disease progression. Since the disease shows a variable progression with a sudden worsening of the clinical symptoms, a comprehensive monitoring of the laboratory parameters serves to diagnose and treat the disease progression.
BACKGROUND: The novel coronavirus (COVID-19) infection continues to wreak havoc across the developed world and now seems to have gained a strong foothold in developing countries including India. The ...mortality rate in severe/critically ill patients with COVID-19 is high. The present study was conducted to analyze the clinical and laboratory markers that discriminate severe/critically ill patients from those with mild/moderate COVID infection early for better clinical management of the disease. METHODS: This laboratory-based, cross-sectional study was conducted on 517 confirmed cases of COVID-19 disease. The patients were divided into mild/moderate and severe/critical groups. Correlation analysis between COVID-19 disease severity and clinical and biochemical parameters was performed on the confirmed COVID-19 infection patients admitted to Shri Vasantrao Naik Government Medical College, Yavatmal, from March 15, 2020, to July 20, 2020. The Pearson correlation coefficient was used for the variables with normal distribution. Cut-off values for critically ill patients were speculated through the receiver-operating characteristics (ROC) curve. RESULTS: The study population included 517 confirmed cases of COVID-19 infection. The median age of the patients was 34 years (IQR: 22–47; range: 18-64 years), with a male to female ratio of 1.2:1. Moreover, 176 (34.04%) patients had one or more co-morbidities, and hypertension (11.5%) and diabetes mellitus (DM) (10.44%) were the most common coexisting co-morbidities. A significant difference was observed between the mild/moderate group and severe/critically ill patients group in the laboratory parameters of serum ferritin, D-dimer, CRP, LDH, prolactin, albumin, ionic calcium, cTnI, and IL6. CONCLUSION: Clinicians should consider age, co-morbidities, and laboratory parameters like lymphopenia, elevated D-dimer levels, elevated CRP, IL6, serum ferritin, cTnI, and
Common laboratory parameters are crucial in aiding coronavirus disease 2019 (COVID-19) case detection. This study aimed to determine the differences between laboratory parameters in (1) COVID-19 ...versus non-COVID-19 pneumonia, and (2) severe versus non-severe COVID-19 cases.
Studies were collected until March 2020, and retrieved parameters include leukocyte, neutrophil, thrombocyte, and lymphocyte counts in addition to C-reactive protein (CRP), procalcitonin (PCT) and D-dimer levels. In the presence of heterogeneity, the random-effect model (REM) was used instead of the fixed-effect model (FEM).
Seven studies in the first analysis showed significantly lower leukocyte, neutrophil and platelet counts in COVID-19 pneumonia (SMD=-0.42, 95%CI -0.60 to -0.25, p<0.00001, SMD=-0.23, 95%CI -0.41 to -0.06, p=0.01, SMD=-0.54, 95%CI -0.91 to -0.16, p=0.0005) compared to non-COVID-19 pneumonia. Twenty-six studies in the second analysis showed significantly lower lymphocyte and thrombocyte counts (SMD=-0.56, 95%CI -0.71 to -0.40, p<0.0001, SMD=-0.32, 95%CI -0.49 to -0.15, p=0.0002) and significantly higher leukocyte, neutrophil, D-dimer, and CRP (SMD=0.31, 95%CI 0.07-0.56, p=0.01; SMD=0.44, 95%CI 0.24-0.64, p<0.0001; SMD=0.53, 95%CI 0.31-0.75, p<0.00001; SMD=0.97, 95%CI 0.70-1.24, p<0.00001) in severe COVID-19 compared to non-severe COVID-19.
In conclusion, thrombocyte count is key in both diagnosis and prognosis. Low leukocyte and neutrophil counts are markers of COVID-19 infection, but contrastingly higher counts indicate progressive COVID-19. And although lymphocyte, D-dimer and CRP levels did not demonstrate diagnostic value, all indicate severity of COVID-19. Confirmation of these findings should be performed in future studies.
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