Martín Grau Carla, Benavent Bofill Clara, Picó-Plana Ester, Recio Comí Gemma, Terrón-Puig Margarida, Bastón Paz Natalia, Sans Mateu MaTeresa, Gutiérrez Fornés Cristina
Clinical Chemistry Laboratory, Catalan Institute of Health (ICS)- Camp de Tarragona-Terres de l'Ebre, Joan XXIII University Hospital in Tarragona, Tarragona, Spain.
and Institut d´Investigació Sanitària Pere Virgili, Joan XXIII University Hospital in Tarragona, Tarragona, Spain.
Adv Lab Med. 2020 Oct 29;2(2):237-252. doi: 10.1515/almed-2020-0059. eCollection 2021 May.
Coronavirus disease 2019 (COVID-19) is widely spreading and represents a critical threat to global health. In the fight against this pandemic, provincial hospitals urgently need rapid diagnostic of COVID-19 infected patients to avoid collapsing of emergency units. However, the high demand of patients with severe acute respiratory symptoms limits the fast delivery of results by the gold standard method reverse transcription-polymerase chain reaction real time (rRT-PCR) for the identification of COVID-19 positive pneumonia. The principal aim is to find other useful laboratory indicators to assist rRT-PCR tests and to help controlling of this outbreak.
Blood, coagulation and inflammatory parameters were collected from a total of 309 patients classified as negative (128) and positive (181) rRT-PCR test groups. Patients were classified as positive by molecular diagnostic test.
Leukocyte count (WBC), neutrophils count, lymphocytes count and lactate dehydrogenase (LDH) were statistically different between both groups of patients. The use of LDH/WBC ratio increases the diagnostic performance with the best area under the curve (0.783), sensibility (82%) and the best percentage (80.5%) of correctly identified COVID-19 positive patients.
The combination of predictive LDH/WBC ratio with clinical illness features could help in medical management of patients and improve the technical resources of hospitals, especially in a critical scenario with a large shortage of medical equipment and lack of reagents for performing rRT-PCR.
2019冠状病毒病（COVID-19）正在广泛传播，对全球健康构成重大威胁。在抗击这一疫情的过程中，省级医院迫切需要快速诊断COVID-19感染患者，以避免急诊科室不堪重负。然而，对出现严重急性呼吸道症状患者的高需求限制了通过用于鉴定COVID-19阳性肺炎的金标准方法实时逆转录-聚合酶链反应（rRT-PCR）快速出具检测结果。主要目的是寻找其他有用的实验室指标来辅助rRT-PCR检测，并有助于控制此次疫情爆发。
从总共309例患者中收集血液、凝血和炎症参数，这些患者被分为rRT-PCR检测阴性（128例）和阳性（181例）组。患者通过分子诊断测试被分类为阳性。
两组患者的白细胞计数（WBC）、中性粒细胞计数、淋巴细胞计数和乳酸脱氢酶（LDH）存在统计学差异。使用LDH/WBC比值可提高诊断性能，曲线下面积最佳（0.783），敏感度（82%）以及正确识别COVID-19阳性患者的最佳百分比（80.5%）。
将具有预测性的LDH/WBC比值与临床疾病特征相结合，有助于对患者进行医疗管理，并改善医院的技术资源，尤其是在医疗设备严重短缺且缺乏用于进行rRT-PCR的试剂的危急情况下。
