Диагностическая точность лабораторных тестов в прогнозе тяжести течения COVID-19

Abstract

Aim. The study of laboratory deviations in homeostasis is one of the main ways to control the severity of the course of COVID-19 and its treatment. In this connection, the goal is set: based on a review of literary publications and our own research, to assess the results of various tests in critically ill patients and to determine their diagnostic accuracy in predicting the severity of COVID-19. Materials and methods. Analyzed 35 literary sources of information and the material of our own research on the diagnostic accuracy of tests in determining severe forms of the disease conducted in 46 patients with COVID-19. Results. The results of test studies in severe patients with COVID-19 showed, in most cases, lymphopenia, thrombocytopenia, an increase in CRP and d-dimer, and transaminase activity. Their ambiguity in assessing the severity and prognosis of the disease was noted. Their diagnostic accuracy in determining the prognosis of the development of severe forms of the disease has been relatively rarely studied. The most accurate results in assessing the prognosis of the severity of the course of COVID-19 were obtained in the study of CRP and test associations in various combinations and ratios. Conclusion. Our own study of lymphocytopenia, thrombocytopenia, d-dimer showed their low diagnostic quality in identifying severe patients with COVID-19. The sensitivity, specificity and predictive value of positive results were less than 50%. Exceeding these limits was obtained in the study of CRP, which determines its leading role in assessing the severity of the course of COVID-19. All tests in the studied values, except for CRP, did not have sufficient qualities to determine the severe condition of patients, which does not allow their use for self-testing of a severe course of infection. This requires the study of tests with values significantly higher than the norm. The use of test combinations, as well as their interconnection, made it possible, in a number of cases, with high diagnostic accuracy to predict the severe course of COVID-19, but this direction of studying the control of the course of infection requires further analysis.