 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2023, vol. 29, issue3
Subject Area: Medicine
-
DOI: 10.5272/jimab.2023293.5026
Published online: 21 July 2023
Original article
J of IMAB. 2023 Jul-Sep;29(3):5026-5030
CHARACTERISTIC CHANGES IN SOME CLINICAL LABORATORY PARAMETERS OF THE SARS-COV-2 INFECTION IN THE COURSE OF THE DISEASE
Pavlina Teneva
, Ivelina Dobreva,
Department of Health Care, Medical College, Trakia University, Stara Zagora, Bulgaria.
ABSTRACT:
Global coronavirus disease 2019 (COVID-19) has posed major challenges to clinical laboratories, from initial diagnosis to patient monitoring and treatment. Some routine laboratory markers reveal a range of changes in patients with COVID-19. Among the most frequently observed are: increased levels of C-Reactive Protein (CRP), Lactate dehydrogenase (LDH), D-Dimer neutrophilia with lymphopenia and decreased platelet count.
The aim of our study is to present the changes in the values of CRP, LDH, D-Dimer, number of Thrombocytes (PLT), Lymphocytes (Ly) and Neutrophils (Neu) during hospitalization and at the discharge of patients with Sars-Cov-2.
Materials and methods: The object of the study are clinical laboratory results of 106 patients who underwent hospital treatment for Covid -19 in the "St. Ivan Rilski" St. Zagora, divided into two groups. The first group (Group I) is in the period November-December 2020, the second group (Group II) patients were hospitalized in April 2021. The values of CRP, LDH, D-Dimer, number of platelets, Ly, Neu from the day of the patient's admission to the hospital and from his discharge were examined.
Results and discussion: In 100% of the examined patients in the first group CRP with values at the time of admission to the hospital (TAH) 88.70 ± 63.132 mg/L. LDH was increased in three of the groups in more than 90% of the patients, with the highest values of the enzyme being recorded in Group II at the end of hospitalization, 802.33 U/L (± 557.836). In the studied groups, we found significantly more patients with elevated values in both groups at discharge (Group I 49.12% and Group II 46.94%). The highest number of patients with thrombocytopenia was observed in Group II at the time of admission to the hospital, 26.53% (n=13).
Conclusion: Quantification of these and other laboratory parameters could significantly aid the detection of at-risk patients and reveal disease severity. They represent objective and standardized criteria guiding therapy.
Keywords: Sars-Cov-2, CRP, LDH, D-dimer, PLT,
- Download FULL TEXT /PDF 494 KB/
Please cite this article as: Teneva P, Dobreva I. Characteristic changes in some clinical laboratory parameters of the Sars-Cov-2 infection in the course of the disease. J of IMAB. 2023 Jul-Sep;29(3):5026-5030. [Crossref - 10.5272/jimab.2023293.5026]
Correspondence to: Pavlina Teneva, Department of Health Care, Medical College - Trakia University, Stara Zagora; 9, Armeyska Str., Stara Zagora, Bulgaria; E-mail: pavlina.teneva@trakia-uni.bg
REFERENCES:
1. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nature Microbiology. 2020 Mar;5:536-544. [PubMed]
2. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020 Jun 25;58(7):1131-1134. [PubMed]
3. Bohn MK, Lippi G, Horvath A, Sethi S, Koch D, Ferrari M, et al. Molecular, serological, and biochemical diagnosis and monitoring of COVID-19: IFCC taskforce evaluation of the latest evidence. Clin Chem Lab Med. 2020 Jun 25;58(7):1037-1052. [PubMed]
4. Poggiali E, Zaino D, Immovilli P, Rovero L, Losi G, Dacrema A, et al. Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in CoVID-19 patients. Clin Chim Acta. 2020 Oct;509:135-138. [PubMed]
5. Keykavousi K, Nourbakhsh F, Abdollahpour N, Fazeli F, Sedaghat A, Soheili V, et al. A Review of Routine Laboratory Biomarkers for the Detection of Severe COVID-19 Disease. Int J Anal Chem. 2022 Oct 11; 2022:9006487. [PubMed]
6. Sadeghi-Haddad-Zavareh M, Bayani M, Shokri M, Ebrahimpour S, Babazadeh A, Mehraeen R, et al. C-Reactive Protein as a Prognostic Indicator in COVID-19 Patients. Interdiscip Perspect Infect Dis. 2021 Apr 23; 2021:5557582. [PubMed]
7. Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. 2020 Jun;50(4):332-334. [PubMed]
8. Chen R, Sang L, Jiang M, Yang Z, Jia N, Fu W, et al. Medical Treatment Expert Group for COVID-19. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020 Jul;146(1):89-100. [PubMed]
9. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020 May;18(5):1094-1099. [PubMed]
10. Waris A, Din M, Khalid A, Abbas Lail R, Shaheen A, Khan N, et al. Evaluation of hematological parameters as an indicator of disease severity in Covid-19 patients: Pakistan’s experience. J Clin Lab Anal. 2021 Jun;35(6): e23809. [PubMed]
11. Mardani R, Ahmadi Vasmehjani A, Zali F, Gholami A, Mousavi Nasab SD, Kaghazian H, et al. Laboratory Parameters in Detection of COVID-19 Patients with Positive RT-PCR; a Diagnostic Accuracy Study. Arch Acad Emerg Med. 2020 Apr 4;8(1):e43. [PubMed]
12. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5):475-481. [PubMed]
13. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020 Feb 15;395(10223):507-513. [PubMed]
14. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis.Clin Chem Lab Med.2020 Jun 25;58(7):1021–1028. [PubMed]
15. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020 Jul 28;71(15):762-768. [PubMed ]
16. Song H, Kim HJ, Park KN, Kim SH, Oh SH, Youn CS. Neutrophil to lymphocyte ratio is associated with in-hospital mortality in older adults admitted to the emergency department. Am J Emerg Med. 2021 Feb;40:133-137. [PubMed]
17. Zeng F, Li L, Zeng J, Deng Y, Huang H, Chen B, Deng G. Can we predict the severity of coronavirus disease 2019 with a routine blood test? Pol Arch Intern Med. 2020 May 29;130(5):400-406. [PubMed]
18. Akdogan D, Guzel M, Tosun D, Akpinar O. Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission. J Infect Dev Ctries. 2021 Jun 30;15(6):766-772. [PubMed]
19. Han Y, Zhang H, Mu S, Wei W, Jin C, Tong C, et. al. Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study. Aging (Albany NY). 2020 Jun 24;12(12):11245-11258. [PubMed]
20. Tripodi A. D-dimer testing in laboratory practice. Clin Chem. 2011 Sep;57(9):1256-1262. [PubMed]
21. Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et. al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020 Jun;18(6):1324-1329. [PubMed]
22. Mei H, Luo L, Hu Y. Thrombocytopenia and thrombosis in hospitalized patients with COVID-19. J Hematol Oncol. 2020 Dec 1;13(1):161. [PubMed].
Received: 06 March 2023
Published online: 21 July 2023