Routine blood tests as a potential diagnostic tool for COVID-19: Clinical Chemistry and Laboratory Medicine

D. Ferrari, A. Motta, Marta Strollo, G. Banfi, M. Locatelli

Research output: Contribution to journalArticlepeer-review


The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to date, the epidemic has gradually spread to 209 countries worldwide with more than 1.5 million infected people and 100,000 deaths. Amplification of viral RNA by rRT-PCR serves as the gold standard for confirmation of infection, yet it needs a long turnaround time (3-4 h to generate results) and shows false-negative rates as large as 15%-20%. In addition, the need of certified laboratories, expensive equipment and trained personnel led many countries to limit the rRT-PCR tests only to individuals with pronounced respiratory syndrome symptoms. Thus, there is a need for alternative, less expensive and more accessible tests. We analyzed the plasma levels of white blood cells (WBCs), platelets, C-reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase and lactate dehydrogenase (LDH) of 207 patients who, after being admitted to the emergency room of the San Raffaele Hospital (Milan, Italy) with COVID-19 symptoms, were rRT-PCR tested. Of them, 105 tested positive, whereas 102 tested negative. Statistically significant differences were observed for WBC, CRP, AST, ALT and LDH. Empirical thresholds for AST and LDH allowed the identification of 70% of either COVID-19-positive or-negative patients on the basis of routine blood test results. Combining appropriate cutoffs for certain hematological parameters could help in identifying false-positive/negative rRT-PCR tests. Blood test analysis might be used as an alternative to rRT-PCR for identifying COVID-19-positive patients in those countries which suffer from a large shortage of rRT-PCR reagents and/or specialized laboratory. © 2020 2020 Walter de Gruyter GmbH, Berlin/Boston.
Original languageEnglish
Pages (from-to)1095-1099
Number of pages5
JournalClin. Chem. Lab. Med.
Issue number7
Publication statusPublished - 2020


  • aspartate aminotransferase
  • blood test
  • COVID-19
  • lactate dehydrogenase
  • RT-PCR
  • WBC
  • alanine aminotransferase
  • alkaline phosphatase
  • C reactive protein
  • gamma glutamyltransferase
  • biological marker
  • virus RNA
  • adult
  • alanine aminotransferase blood level
  • alkaline phosphatase blood level
  • Article
  • aspartate aminotransferase blood level
  • basophil count
  • blood analysis
  • blood sampling
  • colorimetry
  • coronavirus disease 2019
  • coughing
  • emergency ward
  • eosinophil count
  • false negative result
  • false positive result
  • fatigue
  • female
  • fever
  • gamma glutamyl transferase blood level
  • human
  • immunoturbidimetry
  • lactate dehydrogenase blood level
  • leukocyte count
  • lymphocyte count
  • major clinical study
  • male
  • medical examination
  • middle aged
  • monocyte
  • neutrophil count
  • observational study
  • platelet count
  • priority journal
  • real time polymerase chain reaction
  • retrospective study
  • Severe acute respiratory syndrome coronavirus 2
  • aged
  • Betacoronavirus
  • blood
  • blood examination
  • Coronavirus infection
  • Italy
  • laboratory
  • leukocyte
  • pandemic
  • pathogenicity
  • procedures
  • thrombocyte
  • very elderly
  • virus pneumonia
  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase
  • Alkaline Phosphatase
  • Aspartate Aminotransferases
  • Biomarkers
  • Blood Platelets
  • C-Reactive Protein
  • Coronavirus Infections
  • Female
  • gamma-Glutamyltransferase
  • Hematologic Tests
  • Humans
  • L-Lactate Dehydrogenase
  • Laboratories
  • Leukocytes
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral
  • Real-Time Polymerase Chain Reaction
  • Retrospective Studies
  • RNA, Viral
  • SARS-CoV-2


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