Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID‐19

Abstract

The role of clinical laboratory data in the differential diagnosis of the severe forms of COVID-19 has not been definitely established. The aim of this study was to look for the warning index in severe COVID-19 patients. We investigated 43 adult patients with COVID-19. The patients were classified into mild group (28 patients) and severe group (15 patients). A comparison of the hematological parameters between the mild and severe groups showed significant differences in interleukin-6 (IL-6), D-dimer (D-D), glucose, thrombin time, fibrinogen, and C-reactive protein (P < .05). The optimal threshold and area under the receiver operator characteristic curve (ROC) of IL-6 were 24.3 and 0.795 µg/L, respectively, while those of D-D were 0.28 and 0.750 µg/L, respectively. The area under the ROC curve of IL-6 combined with D-D was 0.840. The specificity of predicting the severity of COVID-19 during IL-6 and D-D tandem testing was up to 93.3%, while the sensitivity of IL-6 and D-D by parallel test in the severe COVID-19 was 96.4%. IL-6 and D-D were closely related to the occurrence of severe COVID-19 in the adult patients, and their combined detection had the highest specificity and sensitivity for early prediction of the severity of COVID-19 patients, which has important clinical value. K E Y W O R D S D-dimer, diagnostic utility, IL-6, the severe COVID-19

COVID-19 pathophysiology: A review

“…As in line with the high prevalence of multi-organ failure, high d-dimer levels, fibrinogen and prolonged thrombin time were seen in severe diseases (17). fatality rate of 7.2% (15, 18), which was three times as high as the one in China.…”

COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up

“…Data related to other tests are less certain and often contradictory (24,25). Disease severity is variably associated with prolongation of the prothrombin time (PT) and international normalized ratio (INR) (1,20,26), and thrombin time (TT) (27), and variably by a trend toward shortened activated partial thromboplastin time (aPTT) (1,16,19,28). Recently, Tang et al (7) assessed 183 patients with COVID-19, 21 of whom (11.5%) died.…”

Interleukin-6 as a potential biomarker of COVID-19 progression

“…We initially identified 73 articles based on our search strategy, 64 of which were excluded after title, abstract, or full-text reading, because they were review articles, did not report IL-6 levels, or did not classify the condition of COVID-19 patients as non-severe and severe. Finally, only nine studies were included in this meta-analysis [1][2][3][4][5][6][7][8][9]. Although the heterogeneity was considerably high (I 2 = 89%; P < 0.00001), we observed that IL-6 levels were significantly increased in COVID-19-infected patients with severe condition compared with those with non-severe condition (SMD = 0.71, 95%CI −0.31-1.12, P = 0.0005) ( Fig.…”