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Identification of parameters in routine blood and coagulation tests related to the severity of COVID-19
Rongrong Ding1, Zongguo Yang2, Dan Huang1
1Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Insights
Simple blood markers like high-sensitivity C-reactive protein (hsCRP) and fibrinogen degradation products (FDPs) can predict severe coronavirus disease 2019 (COVID-19). Elevated hsCRP and FDP levels indicate a higher risk of severe illness, aiding in early patient triage.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Hematology
Background:
- Coronavirus disease 2019 (COVID-19) presents a wide spectrum of illness severity.
- Identifying early predictors of severe COVID-19 is crucial for timely intervention and resource allocation.
Purpose of the Study:
- To evaluate the predictive value of routine blood and coagulation tests for COVID-19 severity.
- To identify simple, accessible markers for early risk stratification of COVID-19 patients.
Main Methods:
- Retrospective analysis of 311 COVID-19 patients, categorized by disease severity.
- Logistic regression modeling and Receiver Operating Characteristic (ROC) curve analysis to assess predictive markers.
- Comparison of laboratory parameters including lymphocyte count, eosinophil count, hsCRP, procalcitonin, and coagulation factors between mild/moderate and severe/life-threatening groups.
Main Results:
- Severe COVID-19 patients exhibited significantly lower lymphocyte and eosinophil counts.
- Elevated levels of hsCRP, procalcitonin, and coagulation parameters were observed in the severe COVID-19 group.
- hsCRP (OR=1.072) and FDPs (OR=1.831) were identified as significant predictors of severe COVID-19, with AUCs of 0.850 and 0.766, respectively.
Conclusions:
- Serum hsCRP and FDP levels are positively correlated with COVID-19 severity.
- hsCRP and FDP serve as potential early biomarkers for identifying patients at risk of developing severe illness.
- These markers can assist clinicians in rapid patient triage during high-volume periods.
Abstract:
Objective: This study aimed to identify the predictive value of simple markers in routine blood and coagulation tests for the severity of coronavirus disease 2019 (COVID-19). Methods: A total of 311 consecutive COVID-19 patients, including 281 patients with mild/moderate COVID-19 and 30 patients with severe/life-threatening COVID-19, were retrospectively enrolled. Logistic modeling and ROC curve analyses were used to assess the indexes for identifying disease severity. Results: Lymphocyte and eosinophil counts of COVID-19 patients in the severe/life-threatening group were significantly lower than those of patients in the mild/moderate group (P < 0.001). Coagulation parameters, high-sensitivity C-reactive protein (hsCRP) levels and procalcitonin levels were higher in the severe/life-threatening group compared with the mild/moderate group (all P < 0.05). Univariate and multivariate logistic models revealed that hsCRP and fibrinogen degradation products (FDPs) were predictors of severe COVID-19 (OR = 1.072, P = 0.036; and OR = 1.831, P = 0.036, respectively). The AUROCs of hsCRP and FDP for predicting severe/life-threatening COVID-19 were 0.850 and 0.766, respectively. The optimal cutoffs of hsCRP and FDP for the severe/life-threatening type of COVID-19 were 22.41 mg/L and 0.95 µg/ml, respectively. Conclusion: Serum CRP and FDP levels are positively related to the severity of COVID-19. This finding indicates that CRP and FDP levels may potentially be used as early predictors for severe illness and help physicians triage numerous patients in a short time.
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