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Published on: December 19, 2020
Laboratory predictors of severe Coronavirus Disease 2019 and lung function in followed-up
Min Pan1,2,3, Rui-Rui Wang1,4,5, Xu Chen1,2,3
1Department of Geriatric Respiratory and Critical Care, the First Affiliated Hospital of Anhui Medical University, Hefei, PR China.
Insights
Elevated C-reactive protein (CRP), serum amyloid A (SAA), interleukin-6 (IL-6), and D-dimer can predict severe Coronavirus Disease 2019 (COVID-19). Combining these markers improves prediction accuracy for severe COVID-19 cases.
Area of Science:
- Infectious Diseases
- Immunology
- Pulmonology
Background:
- The Coronavirus Disease 2019 (COVID-19) pandemic, caused by SARS-CoV-2, resulted in millions of infections and deaths globally by the end of 2020.
- Understanding predictors of severe COVID-19 and its impact on lung function is crucial for patient management.
Purpose of the Study:
- To identify laboratory predictors of severe Coronavirus Disease 2019 (COVID-19).
- To assess the impairment of lung function in patients who recovered from COVID-19.
Main Methods:
- Clinical data from diagnosed COVID-19 patients were collected.
- Lung function tests were performed on followed-up patients in Fuyang, Anhui province.
- Laboratory markers including C-reactive protein (CRP), serum amyloid A (SAA), interleukin-6 (IL-6), and D-dimer were analyzed for their predictive value.
Main Results:
- Of 155 patients, 30 (19.35%) had critical illness. Fever was the most common symptom (84.52%).
- Lymphopenia was observed in 47.7% of patients. Elevated CRP, SAA, IL-6, and D-dimer were common.
- The combination of CRP, SAA, IL-6, and D-dimer showed an AUC of 0.823 for predicting severe COVID-19.
Conclusions:
- Elevated CRP, SAA, IL-6, and D-dimer are significant predictors of severe COVID-19.
- Combining these four markers enhances the accuracy and specificity of assessing COVID-19 severity.
- Most follow-up patients had normal lung function, with abnormalities primarily affecting diffusion capacity.
Background:
A pandemic caused by SARS-CoV-2 has infected more than 79 million people and killed exceeding 1.7 million people around the world by the end of 2020.
Method:
We obtained the clinical data of all diagnosed patients and lung function test of followed-up patients in Fuyang, Anhui province to investigate laboratory predictors of severe Coronavirus Disease 2019 (COVID-19) and the impairment of lung function.
Results:
Of the 155 patients, 87 (56.13%) were males. The mean age was 41.95 (SD 15.34) years. Only 30 (19.35%) patients had the critical condition. Fever (84.52%) was the most common symptoms, and short of breath was more common in severe patients (p < 0.01). Lymphopenia was observed in most patients (74, 47.7%). It showed the elevation of CRP in 100 (64.5%) patients, the elevation of SAA or IL-6 in 104 (67.1%) patients. The calculated cut-off value of CRP was 19.35 mg/ml, the AUC was 0.777, sensitivity was 73.3%, specificity was 69.6%; SAA was 73.55 mg/L, 0.679, 83.3%, 56.8%, respectively; IL-6 was 18.85 pg/ml, 0.797, 83.3%, 64.8%; D-Dimer was 0.325 mg/L, 0.673, 66.7% and 68.8%. The combination of CRP, SAA, IL-6, and D-Dimer was 0.823 in AUC, 73.3% in sensitivity, and 78.4% in specificity. 12 (42.86%) followed-up patients had completely normal lung function indicators.
Conclusion:
Elevated CRP, SAA, IL-6 and D-Dimer can be predictors to severe COVID-19. The combination of these four indicators can improve the effectivity and specificity of assessing severe COVID-19. Most of the followed-up patients showed no abnormalities in lung function test. Abnormal lung function is mainly reflected in the diffusion function.
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