Promotion Covid-19 Biochemistry Diagnosis
ROLE OF LABORATORY TESTS IN
COVID-19 PROGNOSIS Bintu Lijo, Manager - Customer Technical Support, AGAPPE.
Several coronaviruses can infect humans, the globally endemic human coronaviruses HCoV-229E, HCoV-NL63, HCoVHKU1 and HCoV-OC43 that tend to cause mild respiratory disease, and the zoonotic Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) that have a higher case fatality rate. In December 2019, a cluster of patients with a novel coronavirus was identified in Wuhan, China. Initially tentatively named 2019 novel coronavirus (2019-nCoV), the virus has now been named SARS-CoV-2 by the International Committee of Taxonomy of Viruses (ICTV). This virus can cause the disease named coronavirus disease 2019 (COVID-19). WHO refers to the virus as COVID-19 virus in its current documentation. The purpose of this article is to provide interim guidance to laboratories and stakeholders involved in COVID-19 virus laboratory testing of patients
The International Federation of Clinical Chemistry and Labo-
ratory Medicine (IFCC) has recently posted a list of laboratory tests (Ref. Table 1) for monitoring patients with COVID-19. Besides hematology (i.e. Complete Blood Count) and coagulation
(i.e. D-Dimer and Prothrombin Time), the list also includes specific clinical chemistry tests for the biochemical monitoring of patients with COVID-19, which are supported by the initial clinical course of patients from Wuhan, China.
Table 1
Here I would like to discuss 4 important parameters in detail.
Laboratory Test
Abnormalities
*Complete Blood Count Increased WBC Increased Neutrophil Count
Potential Clinical Significance Bacterial infection Bacterial infection
Decreased Lymphocyte Count Decreased immunological response to virus Decreased Platelet Count
Disseminated Coagulopathy
Blood gases
Estimated modifications
Important in clinical care management
*Albumin
Decreased
Impaired liver function
*LDH
Increased
Pulmonary injury
*SGOT/SGPT
Increased
Liver injury
*Total Bilirubin
Increased
Liver injury
*Creatinine
Increased
Kidney injury
*Urea
Increased
Kidney injury
*Cardiac Troponin
Increased
Cardiac injury
*D -Dimer
Increased
Activation of coagulation/coagulopathy
*CRP
Increased
Severe viral infection
*Ferritin
Increased
Severe inflammation
*IgG/IgM
Increased
Valuable tool in combination with Ag testing
*Procalcitonin
Increased
An indicator of disease severity
*Available with Agappe
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TECHAGAPPE
OCTOBER - DECEMBER 2020
1.CRP What is CRP? CRP (C – Reactive Protein) is a cytokine -induced, acute phase protein that increases in concentration as a result of inflammation. Hence it is used as early marker or indicator of infections and inflammation. The assay of CRP is more sensitive than the erythrocyte sed imentation rate (ESR) and leukocyte count. The CRP levels rise and return to reference ranges more rapidly after the disease has subsided. Why CRP test is important in Covid-19 prognosis? Statistical studies among the COVID-19
