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Routine laboratory tests: Potential practical parameters to detect coronavirus disease-2019 in resource-limited
Bella Stevanny1, Iche Andriyani Liberty2, Mariatul Fadilah3
1Medical Doctor Professional Study Program, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Insights
Routine laboratory tests like lymphopenia and leukocyte count show poor accuracy for diagnosing Coronavirus Disease-2019 (COVID-19). Neutrophil percentage may aid diagnosis in resource-limited settings, warranting further research.
Area of Science:
- Clinical diagnostics
- Infectious disease epidemiology
- Hematology
Background:
- The global Coronavirus Disease-2019 (COVID-19) pandemic necessitates accessible diagnostic methods, especially in resource-limited settings where advanced testing may be unavailable.
- Routine laboratory tests are being investigated as potential tools for COVID-19 diagnosis in point-of-care and mobile laboratory environments.
Purpose of the Study:
- To systematically review the diagnostic accuracy of routine laboratory tests for detecting COVID-19 in suspected patients.
- To evaluate the utility of these tests in resource-limited point-of-care and mobile laboratory settings.
Main Methods:
- A systematic literature search was conducted in PubMed, Cochrane, and Online Wiley Library for studies published between December 2019 and April 2020.
- Study quality was assessed using QUADAS2, and data were presented using PRISMA 2009 Flow Diagram.
Main Results:
- Three studies were included. Lymphopenia demonstrated poor accuracy (AUC 0.075 and 0.624) for COVID-19 detection.
- Neutrophilia showed good accuracy (AUC 0.858) in one study but poor discriminatory ability (AUC 0.65) against community-acquired pneumonia in another.
- Leukocyte count exhibited high variability and poor diagnostic accuracy (AUC 0.112 and 0.624), making it unsuitable as a sole diagnostic parameter.
Conclusions:
- Neutrophil percentage may offer a valuable diagnostic aid for suspected COVID-19 cases in primary care or mobile laboratories within resource-limited countries.
- Further research is required to validate the diagnostic utility of neutrophil percentage for COVID-19.
Introduction:
The diagnosis of Coronavirus Disease-2019 (COVID-19), an ongoing global pandemic with more than 3 million cases worldwide both in developed and developing countries, requires molecular or serological tests that are not available in some settings. This systematic review provides further evidence to assess the diagnostic accuracy of routine laboratory tests to detect COVID-19 in suspected COVID-19 patients in resource-limited point of care and mobile laboratory.
Methodology:
Comprehensive and systematic literature search in electronic databases (PubMed, Cochrane, and Online Wiley Library) was conducted to retrieve studies published between December 2019 and April 2020 reporting the diagnostic value of routine laboratory tests in the diagnosis of COVID-19. The quality of each study was assessed using QUADAS2. Literature search and study selection were depicted in PRISMA 2009 Flow Diagram.
Results:
Three studies were included in this review. Two studies reported poor accuracy (AUC 0.075 and 0.624) of lymphopenia to detect COVID-19. One study reports good accuracy (AUC 0.858) of neutrophilia to detect COVID-19 amongst suspected cases. One multi-gated cross-sectional study reports poor discriminatory ability (AUC 0.65) of neutrophilia to discriminate between COVID-19 and CAP. Because of its big variability between patients and poor diagnostic accuracy (AUC 0.112 and 0.624), leukocyte count should not be a single parameter to determine COVID-19 patient status.
Conclusions:
Neutrophil percentage might be helpful to determine COVID-19 status for suspected patients at the primary point of care or even in a mobile laboratory for countries with limited resources, but further study is needed to support this statement.
