Biochemistry tests in hospitalized COVID-19 patients: Experience from a Canadian tertiary care centre

Abstract

Background Coronavirus Disease 2019 (COVID-19) has variable clinical presentation, from asymptomatic to severe disease leading to death. Biochemical markers may help with management and prognostication of COVID-19 patients; however, their utility is still under investigation. Methods A retrospective study was conducted to evaluate alanine aminotransferase, C-reactive protein (CRP), ferritin, lactate, and high sensitivity troponin T (TnT) levels in 67 patients who were admitted to a Canadian tertiary care centre for management of COVID-19. Logistic, cause-specific Cox proportional-hazards, and accelerated failure-time regression modelling were performed to assess the associations of initial analyte concentrations with in-hospital death and length of stay in hospital; joint modelling was performed to assess the associations of the concentrations over the course of the hospital stay with in-hospital death. Results Initial TnT and CRP concentrations were associated with length of stay in hospital. Eighteen patients died (27%), and the median initial TnT concentration was higher in patients who died (55 ng/L) than those who lived (16 ng/L; P <0.0001). There were no survivors with an initial TnT concentration >64 ng/L. While the initial TnT concentration was predictive of death, later measurements were not. Only CRP had prognostic value with both the initial and subsequent measurements: a 20% increase in the initial CRP concentration was associated with a 14% (95% confidence interval (CI): 1-29%) increase in the odds of death, and the hazard of death increased 14% (95% CI: 5-25%) for each 20% increase in the current CRP value. While the initial lactate concentration was not predictive of death, subsequent measurements were. Conclusion CRP, lactate and TnT were associated with poorer outcomes and appear to be useful biochemical markers for monitoring COVID-19 patients.

Diabetes Mellitus May Exacerbate Liver Injury in Patients with COVID-19: A Single-Center, Observational, Retrospective Study

“…Recent studies have reported that patients with severe and/or critical COVID-19 have significantly more abnormal liver biochemistry on admission than do patients with less severe disease [ 6 , 13 ] and that high aminotransferase concentrations on admission predict all-cause mortality, especially in patients with severe disease [ 14 ]. However, few studies have investigated the diagnostic and prognostic value of abnormal laboratory findings [ 15 , 16 ]. Therefore, we examined the associations between liver injury and COVID-19 disease severity and comorbidity by analyzing laboratory test results throughout the duration of hospitalization.…”

COVID-19 Impact on Hematological and Biochemical Parameters on Outcomes of Admitted Patients.

“…Patients having COVID-19 symptoms show a high concentration of in ammatory markers like C-reactive protein, creatinine phosphate kinase, lactate dehydrogenase and alanine aminotransferase showing an increase in value (Rutledge et al, 2021). C-receptive protein, lactate dehydrogenase and neutrophils were raised in critical patients, and lymphopenia than in negative cases (Fan, 2020) (Fan et al, 2020).…”

“…On March 31, 2020, World Health Organization announced the public health emergency action plan and takes necessary measures to combat COVID-19. The positive cases may be symptomatic, non-symptomatic, or severely ill (Rutledge et al, 2021). COVID-19 affects the respiratory tract along with other organs including the gastrointestinal system, liver, heart, etc.…”

COVID-19 impact on hematological and biochemical parameters on outcomes of admitted patients

“…Patients having COVID-19 symptoms show a high concentration of inflammatory markers like C-reactive protein, creatinine phosphate kinase, lactate dehydrogenase and alanine aminotransferase showing an increase in value (Rutledge et al, 2021). C-receptive protein, lactate dehydrogenase and neutrophils were raised in critical patients, and lymphopenia than in negative cases (Fan, 2020) (Fan et al, 2020).…”

“…On March 31, 2020, World Health Organization announced the public health emergency action plan and takes necessary measures to combat COVID-19. The positive cases may be symptomatic, non-symptomatic, or severely ill (Rutledge et al, 2021).…”