A biological profile for diagnosis and outcome of COVID-19 patients

Abstract

ObjectivesAs severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) pandemic is increasing its victims on a global scale with recurring outbreaks, it remains of outmost importance to rapidly identify people requiring an intensive care unit (ICU) hospitalization. The aim of this study was to identify Coronavirus Disease 2019 (COVID-19) biomarkers, to investigate their correlation with disease severity and to evaluate their usefulness for follow-up.MethodsFifty patients diagnosed with SARS-Cov-2 were included in March 2020. Clinical and biological data were collected at admission, during hospitalization and one month after discharge. Patients were divided into two severity groups: non-ICU (28) and ICU and/or death (22) to stratify the risk.ResultsBlood parameters in COVID-19 patients at admission showed increased C-reactive protein (CRP) (100%), ferritin (92%), lactate dehydrogenase (LDH) (80%), white blood cell (WBC) count (26%) with lymphopenia (52%) and eosinopenia (98%). There were significant differences in levels of CRP, ferritin, D-dimers, fibrinogen, lymphocyte count, neutrophil count and neutrophil-to-lymphocyte ratio (NLR) among the two severity groups. Mapping of biomarker’s kinetics distinguished early and late parameters. CRP, ferritin, LDH, lymphopenia and eosinopenia were present upon admission with a peak at the first week. Late biomarkers such as anemia, neutrophilia and elevated liver biomarkers appeared after one week with a peak at three weeks of hospitalization.ConclusionsWe confirmed that high-values of CRP, NLR, D-dimers, ferritin as well as lymphopenia and eosinopenia were consistently found and are good markers for risk stratification. Kinetics of these biomarkers correlate well with COVID-19 severity. Close monitoring of early and late biomarkers is crucial in the management of critical patients to avoid preventable deaths.

Time-to-Death Longitudinal Characterization of Clinical Variables and Longitudinal Prediction of Mortality in COVID-19 Patients: A Two-Center Study

“…Lymphopenia was also found to be an early predictor of mortality, consistent with literature review ( 22 , 23 ). We found that in non-survivors, lymphocyte count is lower early in admission, and continues to trend downwards during the hospitalization.…”

Survey of laboratory medicine’s national response to the Covid-19 pandemic in the Republic of Ireland

“…Besides the obvious contribution of diagnosis through RT-PCR, there was also the contribution to patient management and risk stratification for COVID-19 patients through the use of commonly requested test panels such as full blood counts, renal, liver and bone profiles. Testing for additional hyper-inflammatory, cardiac and haemostasis biomarkers [8,[10][11][12][13] was also implemented (or existing capacity increased, where these tests were already available).…”

“…During this time, the development of an expanded spectrum of laboratory tests for patients with confirmed or suspected COVID-19 was completed in Irish laboratories [7,8]. This was done while maintaining essential testing requirements, in the face of expanding health and safety requirements to ensure the protection of members of staff.…”

Can biomarkers of extracellular matrix remodelling and wound healing be used to identify high risk patients infected with SARS-CoV-2?: lessons learned from pulmonary fibrosis

“…The neoepitope technology for the systemic assessment of ECM turnover as a measure of organ fibrosis has previously been described [25,26]. This technology utilizes monoclonal antibodies to detect the generation of newly formed epitopes of collagens and other ECM proteins released during inflammation and fibrosis progression as well as markers of wound healing that can reflect a disturbed coagulation [25,31,36]. The neoepitope technology allows for the detection of both fibrogenesis [32] and fibrolysis of up to twenty-eight different collagens, each contributing to the integrity and quality of the ECM in different organs, including the lungs [26].…”

“…Potentially, markers of ECM remodelling, as [25,26] described here may be used to predict outcome, event at an earlier time point, nevertheless this is speculations. Furthermore, the kinetics of routine clinical markers was followed in fifty patients diagnosed with COVID-19, and admitted to the hospital [36]. Patients were followed during hospitalization and one month prior to discharged, as well as stratified into non-ICU and ICU severity.…”