Role of time-normalized laboratory findings in predicting COVID-19 outcome

Davide Ferrari, Andrea Seveso, Eleonora Sabetta, Daniele Ceriotti, Anna Carobene, Giuseppe Banfi, Massimo Locatelli, Federico Cabitza

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives The pandemic COVID-19 currently reached 213 countries worldwide with nearly 9 million infected people and more than 460,000 deaths. Although several Chinese studies, describing the laboratory findings characteristics of this illness have been reported, European data are still scarce. Furthermore, previous studies often analyzed the averaged laboratory findings collected during the entire hospitalization period, whereas monitoring their time-dependent variations should give more reliable prognostic information. Methods We analyzed the time-dependent variations of 14 laboratory parameters in two groups of COVID-19 patients with, respectively, a positive (40 patients) or a poor (42 patients) outcome, admitted to the San Raffaele Hospital (Milan, Italy). We focused mainly on laboratory parameters that are routinely tested, thus, prognostic information would be readily available even in low-resource settings. Results Statistically significant differences between the two groups were observed for most of the laboratory findings analyzed. We showed that some parameters can be considered as early prognostic indicators whereas others exhibit statistically significant differences only at a later stage of the disease. Among them, earliest indicators were: platelets, lymphocytes, lactate dehydrogenase, creatinine, alanine aminotransferase, C-reactive protein, white blood cells and neutrophils. Conclusions This longitudinal study represents, to the best of our knowledge, the first study describing the laboratory characteristics of Italian COVID-19 patients on a normalized time-scale. The time-dependent prognostic value of the laboratory parameters analyzed in this study can be used by clinicians for the effective treatment of the patients and for the proper management of intensive care beds, which becomes a critical issue during the pandemic peaks.

Original languageEnglish
Pages (from-to)387-394
Number of pages8
JournalDiagnosis
Volume7
Issue number4
DOIs
Publication statusPublished - Nov 18 2020

Keywords

  • Aged
  • Aged, 80 and over
  • Alanine Transaminase/blood
  • Betacoronavirus/genetics
  • Blood Platelets/metabolism
  • C-Reactive Protein/analysis
  • COVID-19
  • Clinical Laboratory Techniques/methods
  • Coronavirus Infections/blood
  • Creatinine/blood
  • Female
  • Hospitalization/statistics & numerical data
  • Humans
  • Italy/epidemiology
  • L-Lactate Dehydrogenase/blood
  • Longitudinal Studies
  • Lymphocytes/metabolism
  • Male
  • Middle Aged
  • Neutrophils/metabolism
  • Pandemics
  • Pneumonia, Viral/blood
  • Prognosis
  • SARS-CoV-2

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