COVID-19 laboratory findings: Difference between revisions
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{{COVID-19}} | |||
{{Main|COVID-19}} | |||
'''For COVID-19 frequently asked inpatient questions, click [[COVID-19 frequently asked inpatient questions|here]]'''<br> | '''For COVID-19 frequently asked inpatient questions, click [[COVID-19 frequently asked inpatient questions|here]]'''<br> | ||
'''For COVID-19 frequently asked outpatient questions, click [[COVID-19 frequently asked outpatient questions|here]]'''<br> | '''For COVID-19 frequently asked outpatient questions, click [[COVID-19 frequently asked outpatient questions|here]]'''<br> | ||
{{CMG}}; {{AE}} {{SHA}} | {{CMG}}; {{AE}} {{SHA}} | ||
Revision as of 15:58, 8 July 2020
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COVID-19 Microchapters |
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COVID-19 laboratory findings On the Web |
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Risk calculators and risk factors for COVID-19 laboratory findings |
For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]
Synonyms and keywords: Lab findings in COVID 19, leukocytosis in COVID 19, thrombocytosis in COVID 19, troponin levels in COVID 19, CRP in COVID 19, ferritin in COVID 19, AST in COVID 19, ALT in COVID 19, procalcitonin in COVID 19, aminotransferase in COVID 19, LDH in COVID 19
Overview
Some other hematological findings in COVID-19 infection include: increase in C-reactive protein (CRP), procalcitonin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, cardiac troponins, decrease in albumin and leukocytosis.
Other Laboratory Findings
Leukocytosis
- Leukocytosis is seen in 11.4% of patients with severe COVID-19 infection compared to 4.8% of patients with non-severe infection.[1][2]
- In patients with COVID-19 infection, leukocytosis may be an indication of a bacterial infection or superinfection.[2]
Increase in C-reactive protein (CRP)
- Increase in CRP is seen in 81.5% of patients with severe COVID-19 infection compared to 56.4% of patients with non-severe infection.[1][2]
- CRP is an acute phase reactant that increases in conditions with inflammation.[3]
- In patients with COVID-19 infection, increase in CRP may be an indication of severe viral infection or sepsis and viremia.[2]
Increase in procalcitonin
- Increase in procalcitonin is seen in 13.7% of patients with severe COVID-19 infection compared to 3.7% of patients with non-severe infection.[1][2]
- In sepsis, the activation and adherence of monocytes increase procalcitonin, therefore procalcitonin in a biomarker for sepsis and septic shock.[4]
- In patients with COVID-19 infection, increase in procalcitonin may be an indication of bacterial infection or superinfection.[2]
Increase in ferritin
- There have been different reports regarding the association of increase in ferritin with death in COVID-19 infection; for example, there has been a report that increase in ferritin is associated with acute respiratory distress syndrome (ARDS) but not death[5], while another one reports an association between increase in ferritin and death in COVID-19 infection[6].
Increase in aspartate aminotransferase (AST)
- Increase in AST is seen in 39.4% of patients with severe COVID-19 infection compared to 18.2% of patients with non-severe infection.[1][2]
- In patients with COVID-19 infection, increase in aminotransferases may indicate injury to the liver or multi-system damage.[2]
Increase in alanine aminotransferase (ALT)
- Increase in ALT is seen in 28.1% of patients with severe COVID-19 infection compared to 19.8% of patients with non-severe infection.[1][2]
- ALT is produced by liver cells and is increased in liver conditions.[3]
- In patients with COVID-19 infection, increase in aminotransferases may indicate injury to the liver or multi-system damage.[2]
Increase in lactate dehydrogenase (LDH)
- Increase in LDH is seen in 58.1% of patients with severe COVID-19 infection compared to 37.2% of patients with non-severe infection.[1][2]
- LDH is expressed in almost all cells and an increase in LDH could be seen in damage to any of the cell types.[3]
- In patients with COVID-19 infection, increase in LDH may indicate injury to the lungs or multi-system damage.[2]
Increase in monocyte volume distribution width (MDW)
- MDW was found to be increased in all patients with COVID-19 infection, particularly in those with the worst conditions.[2]
Increase in total bilirubin
- Increase in total bilirubin is seen in 13.3% of patients with severe COVID-19 infection compared to 9.9% of patients with non-severe infection.[1][2]
- Bilirubin is produced by liver cells and increases in liver and biliary conditions.[3]
- In patients with COVID-19 infection, increase in total bilirubin may indicate injury to the liver.[2]
Increase in creatinine
- Increase in creatinine is seen in 4.3% of patients with severe COVID-19 infection compared to 1% of patients with non-severe infection.[1][2]
- Creatinin is produced in the liver and excreted by the kidneys; creatinine increases when there is decrease in glomerular filtration rate.[3]
- In patients with COVID-19 infection, increase in creatinine may indicate injury to the kidneys.[2]
Increase in cardiac troponins
- In myocardial infarction and acute coronary syndrome are used for diagnosis.[3]
- In patients with COVID-19 infection, increase in cardiac troponins may indicate cardiac injury.[2]
Decrease in albumin
- Albumin may be decreased in many conditions such as sepsis, renal disease or malnutrition.[3]
- In patients with COVID-19 infection, decrease in albumin may indicate liver function abnormality.[2]
Increase in interleukin-6 (IL-6)
Thrombocytosis
Thrombocytosis has been reported in 4% of patients with COVID-19 infection.[7]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 Lippi G, Plebani M (2020). "The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks". Clin Chem Lab Med. 58 (7): 1063–1069. doi:10.1515/cclm-2020-0240. PMID 32191623 Check
|pmid=value (help). - ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Frater JL, Zini G, d'Onofrio G, Rogers HJ (2020). "COVID-19 and the clinical hematology laboratory". Int J Lab Hematol. 42 Suppl 1: 11–18. doi:10.1111/ijlh.13229. PMC 7264622 Check
|pmc=value (help). PMID 32311826 Check|pmid=value (help). - ↑ Meisner M (2014). "Update on procalcitonin measurements". Ann Lab Med. 34 (4): 263–73. doi:10.3343/alm.2014.34.4.263. PMC 4071182. PMID 24982830.
- ↑ 5.0 5.1 Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S; et al. (2020). "Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China". JAMA Intern Med. doi:10.1001/jamainternmed.2020.0994. PMC 7070509 Check
|pmc=value (help). PMID 32167524 Check|pmid=value (help). - ↑ Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z; et al. (2020). "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study". Lancet. 395 (10229): 1054–1062. doi:10.1016/S0140-6736(20)30566-3. PMC 7270627 Check
|pmc=value (help). PMID 32171076 Check|pmid=value (help). - ↑ Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y; et al. (2020). "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study". Lancet. 395 (10223): 507–513. doi:10.1016/S0140-6736(20)30211-7. PMC 7135076 Check
|pmc=value (help). PMID 32007143 Check|pmid=value (help).