The diagnostic process of covıd-19 in the emergency department: laboratory and ımaging methods

Abstract

SUMMARY OBJECTIVES The 2019 Novel coronavirus disease puts a serious burden on the health system. Therefore, the detection of particularly serious patients at an early stage is extremely important in terms of controlling the outbreak and improving the prognosis. We investigated the role of inflammatory markers studied in patients suspected of COVID-19 at an emergency department in predicting PCR and CT results. METHODS This retrospective study was carried out with 133 patients who were admitted between 13 March and 1st April 2020 with suspicion of COVID-19. The patients were divided into four groups according to CT and RT-PCR results and evaluated. RESULTS Considering all patients, no specific findings were found in the hematological and biochemical values of patients in the laboratory analyses. Although all of the results remained within the reference range, there was a significant difference in white blood cell, neutrophil, platelet, and lymphocyte values when the groups were compared [p = 0.000; p = 0.004; p = 0.022; p = 0.023]. CONCLUSION Laboratory is not specific enough in the pre-diagnosis. In addition, this result does not alter with PCR or CT positivity. However, minimal changes observed in laboratory results may be partially guiding in patients in whom both PCR and CT are positive.

BT Görüntüleme Bulgularına Göre Tanı Alan COVID-19 Pozitif ve Olası Hastaları Karşılaştırarak Klinik Karar Vermede BT'nin Kullanılabilirliğinin Araştırılması

“…In another study, CT findings were found to be correlated with the severity and duration of the symptoms of COVID-19, and similar to our study, lymphocyte count was found to be negatively correlated with lung involvement (22). Again, there are studies showing that laboratory findings, such as CRP, ferritin, D-dimer, and lactate are elevated in COVID-19 patients and correlate with the disease severity and mortality (4,(23)(24)(25).…”

What are the factors that affect post COVID 1st month's continuing symptoms?

“…Interestingly few of them show biological anomalies (no lymphocytopenia or elevated C‐reactive protein in particular) and in rare cases, chest computed tomographic scan traces of infection 35 . COVID‐19 laboratory markers are not specific and are of minimal clinical benefit 36 . Lymphocytopenia and an increase in CRP values are the most commonly reported laboratory anomalies in the literature 37,38 .…”

“… 35 COVID‐19 laboratory markers are not specific and are of minimal clinical benefit. 36 Lymphocytopenia and an increase in CRP values are the most commonly reported laboratory anomalies in the literature. 37 , 38 In our study, when the laboratory values of individuals whose symptoms continued after 1 month were examined both the initial and 1 month later D‐dimer and CRP values were found to be higher for those with symptoms.…”

What Are The Factors That Affect Post COVID 1st Month's Continuing Symptoms?

“…Hospitalization is recommended for patients over 50 years of age and all age groups with positive CT findings (12).…”

“…Interestingly few of them show biological anomalies (no lymphocytopenia or elevated C-reactive protein in particular) and in rare cases, chest computed tomographic scan traces of infection (44). COVID-19 laboratory markers are not specific and are of minimal clinical benefit (12).…”