The prognostic value of general laboratory testing in patients with COVID‐19

Abstract

Background Lymphocyte count ( LYM) of peripheral blood and some indices of general biochemical analysis had diagnostic and prognostic value for coronavirus disease 2019 (COVID‐19), and the value of other remaining indices is rare. Methods A total of 94 patients with COVID‐19 were enrolled at Renmin Hospital of Wuhan University. According to the severity of COVID‐19, the patients were divided into three groups (moderate 49, severe 35, and critical 10), and 40 healthy cases were enrolled in the same period as healthy controls. The diagnostic and prognostic value of indices in peripheral blood cell count and general biochemical analysis was analyzed. Results Compared with healthy cases, the value differences in peripheral blood analysis in patients with COVID‐19 were statistically significant ( p < 0.01), the differences in LYM, neutrophil count (Neu), platelet count (PLT), and white blood cell count (WBC) were statistically significant among different severity of COVID‐19 ( p < 0.05). Compared with healthy cases, the differences in general biochemical results in patients with COVID‐19 were statistically significant ( p < 0.01), the value differences in direct bilirubin (DBIL), low‐density lipoprotein cholesterol (LDL‐Ch), and nitrogen (urea) were statistically significant among different severity of COVID‐19 ( p < 0.05). Neutrophil/lymphocyte ratio (NLR) had higher sensitivity and specificity for COVID‐19 diagnosis. Conclusions Some indices of peripheral blood cell count and general biochemical analysis were valuable in discriminating COVID‐19 and predicting severity and adverse outcome of patients with COVID‐19. For clinician, it is better to use more economical and easy‐to‐get indices to diagnose and predict the prognosis of COVID‐19.

Cholesterol and Triglyceride Concentrations, COVID-19 Severity, and Mortality: A Systematic Review and Meta-Analysis With Meta-Regression

“…Eighteen studies assessed total cholesterol concentrations in 4,562 COVID-19 patients, 3,179 (46% males, mean age 56 years) with low severity or survivor status and 1,383 (59% males, mean age 64 years) with high severity or non-survivor status during follow up ( Table 1 ) ( 6 , 7 , 17 , 18 , 20 , 21 , 23 – 26 , 28 – 30 , 32 – 36 ). All studies were conducted in China, except one, performed in France ( 30 ).…”

“…Two studies were prospective ( 29 , 30 ), whilst the remaining 16 were retrospective ( 6 , 7 , 17 , 18 , 20 , 21 , 23 – 26 , 28 , 32 – 36 ). Endpoints included disease severity based on current clinical guidelines in 13 studies ( 6 , 7 , 17 , 21 , 23 , 25 , 26 , 28 , 29 , 32 – 34 , 36 ), ICU admission in two ( 24 , 35 ), and survival status in three ( 18 , 20 , 30 ). The overall standardized mean difference in total cholesterol concentrations between COVID-19 patients with low vs. high severity or survivor vs. non-survivor status is shown in Figure 2 .…”

Low serum level of apolipoprotein A1 may predict the severity of COVID‐19: A retrospective study

“…In a recent study, Wei et al 11 observed that serum levels of TC, HDL‐C, and LDL‐C in patients with COVID‐19 were significantly lower than those in healthy subjects, especially in severe and critical cases, which was similar to our study. Another study also found that LDL‐C performed well in discriminating COVID‐19 severity, it was gradually decreased across moderate, severe, and critical cases; however, HDL‐C exhibited no significant differences among the three groups 12 . These small discrepancies may be related to the heterogeneity of disease severity, different sample sizes, and testing methods.…”

“…Another study also found that LDL‐C performed well in discriminating COVID‐19 severity, it was gradually decreased across moderate, severe, and critical cases; however, HDL‐C exhibited no significant differences among the three groups. 12 These small discrepancies may be related to the heterogeneity of disease severity, different sample sizes, and testing methods. However, our study and others 11 , 12 all showed that blood lipids have potential auxiliary value in distinguishing severe COVID‐19 patients.…”

“… 12 These small discrepancies may be related to the heterogeneity of disease severity, different sample sizes, and testing methods. However, our study and others 11 , 12 all showed that blood lipids have potential auxiliary value in distinguishing severe COVID‐19 patients.…”