Diagnostic Utility of Clinical Laboratory Data Determinations for Patients With the Severe COVID-19

J Med Virol. 2020 Jul;92(7):791-796. doi: 10.1002/jmv.25770. Epub 2020 Apr 10.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Betacoronavirus / genetics
  • Betacoronavirus / pathogenicity*
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / pathology
  • Clinical Laboratory Techniques / methods
  • Coronavirus Infections / blood
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / pathology
  • Diabetes Complications / blood
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / pathology
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Fibrinogen / metabolism
  • Humans
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / pathology
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Thrombin Time

Substances

  • Biomarkers
  • Blood Glucose
  • Fibrin Fibrinogen Degradation Products
  • IL6 protein, human
  • Interleukin-6
  • fibrin fragment D
  • Fibrinogen
  • C-Reactive Protein

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2