Laboratory Biomarkers Predicting COVID-19 Severity in the Emergency Room

Assandri, Roberto; Buscarini, Elisabetta; Canetta, Ciro; Scartabellati, Alessandro; Viganò, Giovanni; Montanelli, Alessandro

doi:10.1016/j.arcmed.2020.05.011

Cited by 35 publications

(33 citation statements)

References 6 publications

(4 reference statements)

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“…A low oxygen saturation (SaO 2 ) is one of the main criteria for the de nition of a severe case. SaO 2 was found as another candidate marker of progressive severity 28 and also validated in the present study. We comprehensively investigated the relationship between risk factors and the severity of COVID-19 and rst concluded that the integration of NLR with SaO 2 may lead to improved prediction.…”

Section: Discussionsupporting

confidence: 82%

NLR combined with SaO2 predict severe illness among COVID-19 patients: a currently updated model

Zhang

Zeng

Wang

et al. 2020

Preprint

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Objectives: The pandemic of the coronavirus disease 2019 (COVID-19) continuously poses a serious threat to public health, highlighting an urgent need for simple and efficient early detection and prediction. Methods: We comprehensively investigated and reanalyzed the published indexes and models for predicting severe illness among COVID‑19 patients in our dataset, and validated them on an independent dataset. Results: 696 COVID-19 cases in the discovery stage and 337 patients in the validation stage were involved. The AuROC of neutrophil to lymphocyte ratio (NLR) (0.782) was significantly higher than that of the other 11 independent risk indexes in severe outcome prediction. The combination of NLR and oxygen saturation (SaO2) (NLR+SaO2) showed the biggest AuROC calculations with a value of 0.901; with a cut-off value of 0.532, it exhibited 84.2% sensitivity, 88.4% specificity and 86.8% correct classification ratio. Moreover, we first identified that principal component analysis (PCA) is an effective tool to predict the severity of COVID-19. We obtained 86.5% prediction accuracy with 86% sensitivity when PCA was applied to predict severe illness. In addition, to evaluate the performance of NLR+SaO2 and PCA, we compared them with currently published predictive models in the same dataset. Conclusions: It showed that NLR+SaO2 is an appropriate and promising method for predicting severe illness, followed by PCA. We then validated the results on an independent dataset and revealed that they remained robust accuracy in outcome prediction. This study is significant for early treatment, intervention, triage and saving limited resources.

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Section: Discussionsupporting

confidence: 82%

NLR combined with SaO2 predict severe illness among COVID-19 patients: a currently updated model

Zhang

Zeng

Wang

et al. 2020

Preprint

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“…We suggest that the following diagnostic screenings may be appropriately considered during COVID-19 era for patients presenting with the aforementioned symptoms and history: respiratory rate, natriuretic peptides, lymphocyte count, C-reactive protein, D-dimer, fibrinogen, electrocardiogram, and chest X-ray. Analysis of the arterial blood gas could be performed as an additional test to identify the culprit behind the patient's destabilization [12]. Additionally, lung ultrasound could be used as an alternative method to discern a pulmonary lesion associated with interstitial pneumonia or increased comet related to water content [13].…”

Section: Diagnostic Tests and Screening In Patients With Acute Dyspneamentioning

confidence: 99%

Screening, detection, and management of heart failure in the SARS-CoV2 (COVID-19) pandemic

Palazzuoli

Ruocco²,

Tecson

et al. 2021

Heart Fail Rev

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Observational studies suggest that a heart failure (HF) diagnosis carries a poor prognosis in subjects with severe SARS-CoV2 (COVID-19) infection, but it is unknown whether this association reflects direct myocardial damage due to COVID-19 or the consequence of preexisting cardiac defects and related cardiovascular disease (CVD) risk burden. Although the close relation between CVD and COVID-19 outcomes is well established, contrasting data exists about the occurrence of HF complications during COVID-19 infection. Therefore, a specific algorithm focused on diagnostic differentiation in acute patients distinguishing between acute HF and acute respiratory distress syndrome related to COVID-19 is needed. Further, several concerns exist for the management of patients with an uncertain diagnosis and acute dyspnea, the exact relationship existing between COVID-19 and HF. Therefore, the treatment for subjects with both COVID-19 and HF and which criteria may be defined for domiciliary or hospital management, remain poorly defined. Herein, we describe practices to be adopted in order to address these concerns and avoid further virus spread among patients, l and their familiars involved in such patients' care.

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“…Chen C et al 2020 -----0,001 --<0,001 -<0, Atualmente, sabe-se que a COVID-19 pode provocar manifestações clínicas heterogêneas, das quais, ampliam-se uma gama de espectros clínicos, desde uma condição Research, Society andDevelopment, v. 9, n. 11, e2619118955, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i11.8955 assintomática até uma Síndrome Respiratória Aguda (SRA) com risco de óbito (Assandri et al, 2020). Novas cepas de coronavírus com mutações surgiram ao longo dos anos e vem sendo associadas a fatores de virulência aumentados, causando altas taxas de mortalidade entre a população.…”

Section: Valor De P=005 (Pacientes Graves E Não Graves)unclassified

“…Estudos preliminares vêm revelando que testes laboratoriais podem se apresentar alterados em pacientes com a COVID-19 sendo, portanto, indicado como uma alternativa rápida e sensível para a observação e identificação desta doença. O RT-PCR ainda é o teste ouro padrão para diagnóstico, entretanto, outros exames complementares têm sido associados às observações de prognósticos (Assandri et al, 2020). Sendo assim, este artigo de revisão abordou parâmetros laboratoriais associados às características de gravidade de pacientes com COVID-19.…”

Section: Valor De P=005 (Pacientes Graves E Não Graves)unclassified

Associação dos principais parâmetros hematológicos, bioquímicos e imunológicos em pacientes graves e não graves com COVID-19: uma revisão sistemática

Souza

Silva

et al. 2020

RSD

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Introdução: A COVID-19 é uma doença infectocontagiosa causada pelo vírus SARS-CoV-2, responsável por acometer principalmente os pulmões e desencadear patologias respiratórias, como também desenvolver problemas hepáticos, neurológicas e gastrointestinais. O objetivo desta revisão sistemática foi realizar um levantamento de estudos com os principais marcadores laboratoriais de pacientes com COVID-19 relacionando as anormalidades destes resultados com a predição clínica de pacientes graves e não graves. Metodologia: Este estudo foi conduzido seguindo as diretrizes metodológicas de uma Revisão Sistemática de acordo com o protocolo PRISMA, dos quais, realizou-se buscas nas bases eletrônicas PubMed, LILACS, EMBASE, Science, medRxiv, e bioRxiv, utilizando as palavras-chaves: "SARS-CoV-2" OR "COVID-19" OR "Coronavirus" AND “Laboratory Parameters” AND "Exams" OR "Laboratory". Foram utilizados artigos elegíveis publicados a partir de janeiro de 2020 até 20 de maio de 2020, sem restrições de idioma contendo dados laboratoriais hematológicos, bioquímicos e imunológicos. Resultados: De acordo com esta revisão foram selecionados 16 artigos elegíveis. As principais anormalidades foram observadas em pacientes graves com alterações expressivas em alguns parâmetros hematológicos, bioquímicos e imunológicos, sendo estes: ferritina, linfócitos, D-Dímero, LDH, AST, PCR, Procalcitonina, TcnI e IL-6. Conclusão: O presente estudo demonstra a relevância dos exames laboratoriais para auxiliar os profissionais da área da saúde na execução de medidas necessárias e condutas terapêuticas adequadas para o tratamento de pacientes infectados pelo coronavírus.

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Laboratory Biomarkers Predicting COVID-19 Severity in the Emergency Room

Cited by 35 publications

References 6 publications

NLR combined with SaO2 predict severe illness among COVID-19 patients: a currently updated model

NLR combined with SaO2 predict severe illness among COVID-19 patients: a currently updated model

Screening, detection, and management of heart failure in the SARS-CoV2 (COVID-19) pandemic

Associação dos principais parâmetros hematológicos, bioquímicos e imunológicos em pacientes graves e não graves com COVID-19: uma revisão sistemática

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