Abstract
Coronavirus disease 2019 (COVID-19) is widely spreading and represents a critical threat to global health. In the fight against this pandemic, provincial hospitals urgently need rapid diagnostic of COVID-19 infected patients to avoid collapsing of emergency units. However, the high demand of patients with severe acute respiratory symptoms limits the fast delivery of results by the gold standard method reverse transcription-polymerase chain reaction real time (rRT-PCR) for the identification of COVID-19 positive pneumonia. The principal aim is to find other useful laboratory indicators to assist rRT-PCR tests and to help controlling of this outbreak. Blood, coagulation and inflammatory parameters were collected from a total of 309 patients classified as negative (128) and positive (181) rRT-PCR test groups. Patients were classified as positive by molecular diagnostic test. Leukocyte count (WBC), neutrophils count, lymphocytes count and lactate dehydrogenase (LDH) were statistically different between both groups of patients. The use of LDH/WBC ratio increases the diagnostic performance with the best area under the curve (0.783), sensibility (82%) and the best percentage (80.5%) of correctly identified COVID-19 positive patients. The combination of predictive LDH/WBC ratio with clinical illness features could help in medical management of patients and improve the technical resources of hospitals, especially in a critical scenario with a large shortage of medical equipment and lack of reagents for performing rRT-PCR.
Highlights
Coronavirus disease 2019 (COVID-19) was identified by the Chinese Centre for Disease Control and Prevention (CDC) from the throat swab sample of patients with pneumonia of unknown cause [1], and was subsequently named 2019-nCoV by WHO [2]
The use of lactate dehydrogenase (LDH)/WBC ratio increases the diagnostic performance with the best area under the curve (0.783), sensibility (82%) and the best percentage (80.5%) of correctly identified COVID-19 positive patients
The combination of predictive LDH/WBC ratio with clinical illness features could help in medical management of patients and improve the technical resources of hospitals, especially in a critical scenario with a large shortage of medical equipment and lack of reagents for performing reverse transcription-polymerase chain reaction real time (rRT-PCR)
Summary
Coronavirus disease 2019 (COVID-19) was identified by the Chinese Centre for Disease Control and Prevention (CDC) from the throat swab sample of patients with pneumonia of unknown cause [1], and was subsequently named 2019-nCoV by WHO [2]. Since December 2019, COVID-19 is widely spreading and represents a critical threat to global health due to its high incidence and infectivity. Up to the date of May 21st, 2020, around 5,121,639 people have been infected and 333,323 have died [3]. In the fight against this worldwide pandemic, rapid identification of clinical and laboratory predictors of diagnostic and progression toward severe and fatal forms is urgently needed. These predictors are necessary in some Hospital Departments, such as an Emergency Department, for risk stratification, optimization of patient’s allocation in specific areas and correct use of human and technical resources in the course of the pandemic.
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