Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19

Yong Gao, Tuantuan Li, Mingfeng Han, Xiuyong Li, Dong Wu, Yuanhong Xu, Yulin Zhu, Yan Liu, Xiaowu Wang, Linding Wang, Yong Gao, Tuantuan Li, Mingfeng Han, Xiuyong Li, Dong Wu, Yuanhong Xu, Yulin Zhu, Yan Liu, Xiaowu Wang, Linding Wang

Abstract

The role of clinical laboratory data in the differential diagnosis of the severe forms of COVID-19 has not been definitely established. The aim of this study was to look for the warning index in severe COVID-19 patients. We investigated 43 adult patients with COVID-19. The patients were classified into mild group (28 patients) and severe group (15 patients). A comparison of the hematological parameters between the mild and severe groups showed significant differences in interleukin-6 (IL-6), d-dimer (d-D), glucose, thrombin time, fibrinogen, and C-reactive protein (P < .05). The optimal threshold and area under the receiver operator characteristic curve (ROC) of IL-6 were 24.3 and 0.795 µg/L, respectively, while those of d-D were 0.28 and 0.750 µg/L, respectively. The area under the ROC curve of IL-6 combined with d-D was 0.840. The specificity of predicting the severity of COVID-19 during IL-6 and d-D tandem testing was up to 93.3%, while the sensitivity of IL-6 and d-D by parallel test in the severe COVID-19 was 96.4%. IL-6 and d-D were closely related to the occurrence of severe COVID-19 in the adult patients, and their combined detection had the highest specificity and sensitivity for early prediction of the severity of COVID-19 patients, which has important clinical value.

Keywords: IL-6; d-dimer; diagnostic utility; the severe COVID-19.

Conflict of interest statement

The authors declare that there are no conflict of interests.

© 2020 Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Receiver operator characteristic curves comparing the potential of different variables to predict the severe COVID‐19. A, The prediction of the severe COVID‐19 variables for Individual indicators. B, The prediction of the severe COVID‐19 variables for interleukin‐6 (IL‐6) combine with d‐dimer (d‐D). CRP, C‐reactive protein; FIB, fibrinogen; Glu, glucose; TT, thrombin time
Figure 2
Figure 2
Receiver operator characteristic curves of independent and joint detection were obtained when interleukin‐6 (IL‐6) and d‐dimer (d‐D) both took the best critical values. d‐Dimer or IL‐6 represented serial detection. d‐Dimer and IL‐6 represented parallel detection

References

    1. World Health Organization . Coronavirus disease 2019 (COVID‐19) Situation Report‐23. 2020.
    1. Holshue ML, DeBolt C, Lindquist S, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382:929‐936.
    1. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle. J Med Virol. 2020;92(4):401‐402.
    1. Wan SYQ, Fan S, Lv J, et al. Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP). medRxiv. 2020.
    1. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507‐513.
    1. Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology. 2018;23(2):130‐137.
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497‐506.
    1. de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523‐534.
    1. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus‐Infected Pneumonia in Wuhan, China. JAMA. 2020.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться