Can routine laboratory tests discriminate SARS‐CoV‐2‐infected pneumonia from other causes of community‐acquired pneumonia?

Abstract

Background The clinical presentation of SARS‐CoV‐2‐infected pneumonia (COVID‐19) resembles that of other etiologies of community‐acquired pneumonia (CAP). We aimed to identify clinical laboratory features to distinguish COVID‐19 from CAP. Methods We compared the hematological and biochemical features of 84 patients with COVID‐19 at hospital admission and 221 patients with CAP. Parameters independently predictive of COVID‐19 were calculated by multivariate logistic regression. The receiver operating characteristic (ROC) curves were generated and the area under the ROC curve (AUC) was measured to evaluate the discriminative ability. Results Most hematological and biochemical indexes of patients with COVID‐19 were significantly different from patients with CAP. Nine laboratory parameters were identified to be predictive of a diagnosis of COVID‐19. The AUCs demonstrated good discriminatory ability for red cell distribution width (RDW) with an AUC of 0.87 and hemoglobin with an AUC of 0.81. Red blood cell, albumin, eosinophil, hematocrit, alkaline phosphatase, and mean platelet volume had fair discriminatory ability. Combinations of any two parameters performed better than did the RDW alone. Conclusions Routine laboratory examinations may be helpful for the diagnosis of COVID‐19. Application of laboratory tests may help to optimize the use of isolation rooms for patients when they present with unexplained febrile respiratory illnesses.

Diagnostic Value of Platelet Mass Index, Plt/Mpv Ratio and Other Hemogram Parameters in Covid-19 Patients Who Presented to Emergency Department

“…WBC value was found to be significantly lower in COVID-19 patients compared to healthy individuals (30). Similarly, in our study WBC was statistically significantly lower in the PCR (+) group compared to PCR (-) group.…”

“…Consistently with the literature, in our study MPV value was significantly higher in PCR (+) group compared to PCR (-) group. In the study by Pan et al, monocytes count was significantly lower in COVID-19 patients compared to the healthy controls (30). Similarly in the present study monocytes count was significantly lower in PCR (+) group compared to PCR (-) group.…”

COVID‐19 and hematology findings based on the current evidences: A puzzle with many missing pieces

“…Moreover, Yun et al observed that red cell distribution width (RDW) increases in COVID‐19 patients compared to patients with influenza 9 . In contrast to the mentioned study, Pan and colleagues observed a decrease in RDW and an increase in hemoglobin and hematocrit levels in COVID‐19 patients 54 . These studies showed that decreased hemoglobin levels in COVID‐19 patients were associated with the severity of the disease.…”

Association of Red Blood Cell Distribution Width With Mortality Risk in Hospitalized Adults With SARS-CoV-2 Infection

“…Other studies have noted the potential value of using RDW for a differential diagnosis of pneumonia 26 , 27 or as a marker of complication rates in SARS-CoV-2 infection, 28 , 29 , 30 , 31 either directly or as a component of a machine learning framework. Recent small-scale studies have included RDW in multivariate models along with neutrophil-lymphocyte ratio 28 or hemoglobin 26 for a differential diagnosis of COVID-19. The results of the present study show that the use of RDW as a univariate marker relative to its predetermined reference interval (≤14.5%) is associated with substantially increased mortality risk.…”