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Observational Study
. 2021 Sep;9(3):851-861.
doi: 10.1002/iid3.440. Epub 2021 May 7.

Parameters associated with diagnosis of COVID-19 in emergency department

Claudio Ucciferri  1 , Luca Caiazzo  1 , Marta Di Nicola  2 , Paola Borrelli  2 , Michela Pontolillo  1 , Antonio Auricchio  1 , Jacopo Vecchiet  1 , Katia Falasca  1
Affiliations
Observational Study

Parameters associated with diagnosis of COVID-19 in emergency department

Claudio Ucciferri et al. Immun Inflamm Dis. 2021 Sep.

Abstract

Objectives: We designed this study to identify laboratory and radiological parameters, which could be useful to guide the clinician, in the evaluation of a suspected case of coronavirus disease 19 (COVID-19).

Methods: This retrospective, observational, single-center-study recruited patients with a suspect of COVID-19 data were extracted from electronic medical records using a standardized data collection form.

Results: A total of 566 patients with suspect COVID-19 infection were enrolled (280 were COVID-19+). The COVID-19 population was characterized with bilateral-pneumonia, a lower count of neutrophil, lymphocyte and monocyte, a lower neutrophil to lymphocyte-ratio (NLR). Lower of platelet count, d-dimer, troponin I, and serum calcium were in COVID-19 patients. The occurrence of COVID-19 diagnosis increased, independently of other variables, with pneumonia (odds ratio [OR]: 3.60; p < .001), neutrophil below normal range (OR: 4.15; p < .05), lactate dehydrogenase (OR: 2.09; p < .01) and sodium above normal range (OR: 2.34; p < .01). In patients with possible respiratory acute affections we found a higher neutrophil, higher monocyte, a higher NLR and a more elevation in d-dimer. In the Sepsis group showed higher level of white blood cell, C-reactive protein, d-dimer, and procalcitonin.

Conclusions: Our study confirms that patients with COVID-19 have typical radiological and laboratory characteristics. The parameters highlighted in the study can help identify COVID-19 patients, also highlighting which are the main differential diagnoses to be made and the parameters that facilitate the differential diagnosis.

Keywords: ED; SARS-COV2; Sepsis disease; heart failure; respiratory disease.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Crude OR and 95% Cl for identifying factors associated with COVID‐19 diognosis *The laboratory parameters were recoded into three levels: normal range (reference parameter), below normal range, and above normal range. Cl, confidence interval; COVID‐19, coronavirus disease 19; OR, odds ratio
Figure 2
Figure 2
ROC Curve with AUC values (logistic regression model) for COVID‐19 diagnosis. AUC, area under the curve; COVID‐19, coronavirus disease 19; ROC, receiver operator characteristics
Figure 3
Figure 3
K‐fold (10) ROC Curve with mean AUC values. AUC, area under the curve; ROC, receiver operator characteristics
Figure 4
Figure 4
Parameters for COVID‐19 diagnosis. COVID‐19, coronavirus disease 19
See this image and copyright information in PMC

References

    1. Morfeld P, Timmermann B, Gross JV, et al. COVID‐19: spatial resolution of excess mortality in Germany and Italy. J Infect. 2020;82(3):414‐451. - PubMed
    1. Salajegheh Tazerji S, Magalhães Duarte P, Rahimi P, et al. Transmission of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) to animals: an updated review. J Transl Med. 2020;18(1):358. - PMC - PubMed
    1. Ucciferri C, Vecchiet J, Falasca K. Role of monoclonal antibody drugs in the treatment of COVID‐19. World J Clin Cases. 2020;8(19):4280‐4285. - PMC - PubMed
    1. Costela‐Ruiz VJ, Illescas‐Montes R, Puerta‐Puerta JM, Ruiz C, Melguizo‐Rodriguez L. SARS‐CoV‐2 infection: the role of cytokines in COVID‐19 disease. Cytokine Growth Factor Rev. 2020;54:62‐75. - PMC - PubMed
    1. Zhou B, Kojima S, Kawamoto A, Fukushima M. COVID‐19 pathogenesis, prognostic factors, and treatment strategy: urgent recommendations. J Med Virol. 2020;93(5):2694‐2704. - PubMed

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