Cautions on the laboratory indicators of COVID-19 patients on and during admission.

Abstract

BACKGROUND:

Different disease severities of COVID-19 patients could be reflected on clinical laboratory findings.

METHODS:

In this single-centered retrospective study, demographic, clinical, and laboratory indicators on and during admission were compared among 74 participants with mild, moderate, critical severe, or severe classification. Risk factors associated with disease severity were analyzed by multivariate analyses. The AUC and 95% CI of the ROC curve were calculated.

RESULTS:

The most common manifestations of these patients were fever and cough. Critical severe or severe group owned the longest length of stay (23 (19,31), p < 0.001). After multivariate logistic regression, independent influence factors on admission for severity of disease were CK-MB (OR 0.674; 95% CI 0.489-0.928; p = 0.016), LDH (OR 1.111 or 1.107; 95% CI 1.026-1.204 or 1.022-1.199; p = 0.009 or 0.013), normal T-BIL (OR 4.58 × 10-8 ; 95% CI 3.05 × 10-9 -6.88 × 10-7 ; p < 0.001), LYM% (OR 0.008; 95% CI 0-0.602; p = 0.029), and normal ESR (OR 0.016; 95% CI 0-0.498; p = 0.019). Factors during hospitalization were normal T-BIL (OR 8.56 × 10-9 ; 95% CI 8.30 × 10-10 -8.83 × 10-8 ; p < 0.001), LYM (OR 0.068; 95% CI 0.005-0.934; p = 0.044), albumin (OR 0.565; 95% CI 0.327-0.977; p = 0.041), and normal NEU% (OR 0.013; 95% CI 0.000-0.967; p = 0.048). Combined indicators of AUC were 0.860 (LYM, LDH, and normal ESR on admission, p < 0.001) and 0.750 (CK-MB, LDH, and normal T-BIL during hospitalization, p = 0.020) when predicting for severe or critical severe patients.

CONCLUSION:

To pay close attention to the progression of COVID-19 and take measures promptly, we should be cautious of the laboratory indicators when patients on admission especially CK-MB, LDH, LYM%, T-BIL as well as ESR; and T-BIL, LYM, albumin, NEU% with the process of disease.

• Authors: Haiting Liu, Xueling Shang, Sai Chen, Tie Li, Junhua Zhang
• Journal: Journal of clinical laboratory analysis (J Clin Lab Anal) Vol. 35 Issue 5 Pg. e23767 (May 2021) ISSN: 1098-2825 [Electronic] United States
• PMID: 33951237 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.

Chemical References

• L-Lactate Dehydrogenase
• Bilirubin

Topics

• Adult
• Aged
• Bilirubin (blood)
• Blood Sedimentation
• COVID-19 (blood, diagnosis)
• Female
• Humans
• L-Lactate Dehydrogenase (blood)
• Laboratories
• Male
• Middle Aged
• Retrospective Studies
• SARS-CoV-2
• Severity of Illness Index