Baseline laboratory parameters for preliminary diagnosis of COVID-19 among children: a cross-sectional study

Abstract

BACKGROUND: Clinical judgment of initial baseline laboratory tests plays an important role in triage and preliminary diagnosis among coronavirus disease 2019 (COVID-19) patients. OBJECTIVES: To determine the differences in laboratory parameters between COVID-19 and COVID-like patients, and between COVID-19 and healthy children. Additionally, to ascertain whether healthy children or patients with COVID-like symptoms would form a better control group. DESIGN AND SETTING: Cross-sectional study at the Institute for Child and Youth Health Care of Vojvodina, Novi Sad, Serbia. METHODS: A retrospective study was conducted on 42 pediatric patients of both sexes with COVID-19. Hematological parameters (white blood cell count, absolute lymphocyte count and platelet count) and biochemical parameters (natremia, kalemia, chloremia, aspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH] and C-reactive protein [CRP]) were collected. The first control group was formed by 80 healthy children and the second control group was formed by 55 pediatric patients with COVID-like symptoms. RESULTS: Leukocytosis, lymphopenia, thrombocytosis, elevated systemic inflammatory index and neutrophil-lymphocyte ratio, hyponatremia, hypochloremia and elevated levels of AST, ALT, LDH and CRP were present in COVID patients, in comparison with healthy controls, while in comparison with COVID-like controls only lymphopenia was determined. CONCLUSIONS: The presence of leukocytosis, lymphopenia, thrombocytosis, elevated systemic inflammatory index and neutrophil-lymphocyte ratio, hyponatremia, hypochloremia and elevated levels of AST, ALT, LDH and CRP may help healthcare providers in early identification of COVID-19 patients. Healthy controls were superior to COVID-like controls since they provided better insight into the laboratory characteristics of children with novel betacoronavirus (SARS-CoV-2) infection.

Could platelet indices have diagnostic properties in children with COVID‐19?

“…The result of a complete blood count is readily available to any institution and provides valuable information if interpreted carefully. 16 …”

“…In that period, it is very important to adequately evaluate the laboratory parameters that are available immediately upon admission to the hospital. The result of a complete blood count is readily available to any institution and provides valuable information if interpreted carefully 16 …”

“…The result of a complete blood count is readily available to any institution and provides valuable information if interpreted carefully. 16 Many studies have confirmed that platelets, apart from hemostasis and coagulation, play an important role in the inflammatory response to viral infections. The prothrombotic response implies changes in the function of platelets, which is accompanied by changes in their morphology.…”

Hemogram‐based decision tree models for discriminating COVID‐19 from RSV in infants

“…The fact that this virus was not commonly present in the general population now leads not only to an increased incidence of the disease but also to more frequent hospitalizations and more severe clinical forms of this infection. 1 , 2 , 3 …”

“…This phenomenon has been labeled as the “epidemiological debt,” because the occurrence of RSV and other respiratory viruses was almost completely suppressed during the course of non‐pharmacological measures against COVID‐19. The fact that this virus was not commonly present in the general population now leads not only to an increased incidence of the disease but also to more frequent hospitalizations and more severe clinical forms of this infection 1–3 …”