Routine laboratory tests alterations in relation with the severity of coronavirus disease 2019 (COVID-19)

Introduction Coronavirus disease 19 (COVID-19) is the greatest pandemic in modern history The aim of this study was to investigate the alteration and prognostic potential of routine blood tests in a series of consecutive Italian patients with COVID-19 Methods Clinical data and routine laboratory tests of a consecutive series of 62 COVID-19 patients treated in the Units of Infectious and Respiratory Diseases of the University of Sassari from 15 March through 30 April 2020, have been retrospectively collected Differences in laboratory tests performed at hospital admission between COVID-19 survivors and non survivors were statistically searched and analyzed Results Patients in non-survivors group had higher number of WBCs (median: 9 16 x109L;IQR: 6 29-13 07 x109L vs 6 37 x109L;IQR: 4 95-9 04 x109L, p=0 037), neutrophils (mean: 9 2±6 0 x109L vs 5 4±2 7 x109L, p=0 001), and lower lymphocytes number (median: 0 6 x109L;IQR: 0 6-0 85 x109L vs 1 0 x109L;IQR: 0 7-1 2 x109L, p=0 013) In addition, non-survivors showed lower albumin (median: 3 2 g/dL;IQR: 2 9-3 4 g/dL vs 3 5 g/dL;IQR: 3 0-3 9 g/dL, p=0 035), and increased PCR/albumin ratio (median: 3 65;IQR: 2 17-6 86 vs 1 56;IQR: 0 64-4 36, p=0 035) and De Ritis ratio (median: 1 14;IQR: 0 89-1 48 vs 1 73;IQR: 1 29-2 27, p=0 002) Increased levels of LDH (median: 359 IU/L;IQR: 259-504 vs 273 IU/L;IQR: 197-356 IU/L, p=0 017), procalcitonin (median: 0 28 ng/mL;IQR: 0 19-0 52 ng/mL vs 0 07 ng/mL;IQR: 0 03-0 17 ng/mL, p=0 0006) and troponin (median: 0 181 ng/mL;IQR: 0 068-0 193 ng/mL vs 0 004 ng/mL;IQR: 0 000-0 017 ng/mL, p=0 002) has been found in nonsurvivors In ROC curve analysis the better performing indexes were troponin, with a threshold of 0 037 ng/mL, 86% sensitivity and 100% specificity (AUC=0 908, 95% CI 0 701 to 0 989, p<0 001) and procalcitonin with a threshold of 0 18 ng/mL, 79% sensitivity and 79% specificity (AUC=0 807, 95% CI 0 681 to 0 900, p<0 001) Conclusions Differences in routine laboratory test alterations between COVID-19 survivors and nonsurvivors have been detected;troponin and procalcitonin were the biomarkers which showed the highest prognostic abilities in our study