The predictive value of laboratory biomarkers in defining COVID-19 severity

Document Type : Original Article

Authors

1 Resident of Pulmonology, Chest Department, Aswan University, Egypt.

2 MD. Lecturer of Pulmonology, Faculty of Medicine, Aswan University, Egypt.

3 MD. Associate professor of Pulmonology, Aswan Faculty of Medicine, Aswan University, Egypt.

Abstract

Introduction
The COVID-19 outbreak poses a serious hazard to human health. We aimed to correlate between the severity of clinical presentation and hematological (CBC including: lymphocyte count, neutrophil to lymphocyte ratio) and immunological (CRP, serum ferritin, D-Dimer) laboratory results of COVID-19 cases.
Material and methods
All COVID-19 positive cases that were admitted to Aswan University Hospitals were prospectively collected and classified into either severe or non-severe COVID-19 cases rendering to prerequisite for ICU admission. All the demographic, clinical characteristics, HRCT results and the basic laboratory biomarkers at time of admission were collected.
Results
The severe case group (n=71) had considerably higher mean levels of WBCs, absolute neutrophils, absolute lymphocytes, CRP, D-dimer, NLR and ferritin than the non-severe case group (n=137) (p <0.0001 considerably). However, CRP and serum ferritin are considered the independent risk factors for COVID-19 severity (p= 0.009 & 0.033 respectively). Moreover, at a cut-off point (5.73), the sensitivity of NLR ratio to predict the case severity was low (43%) but higher specificity (93.2%). Similarly, at a cut-off point of (1.56), the sensitivity and specificity of D-dimer were (60.6% and 78.1% respectively). Furthermore, at a cut-off point of (256.5), the sensitivity of serum ferritin to predict severity was high (90.1%) but low specificity (38.0%).

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