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Review
. 2021 Sep:10.2217/fvl-2020-0316.
doi: 10.2217/fvl-2020-0316. Epub 2021 Sep 21.

High-value laboratory testing for hospitalized COVID-19 patients: a review

Daniela Cihakova  1 , Michael B Streiff  2 , Steven P Menez  2 , Teresa K Chen  2 , Nisha A Gilotra  2 , Erin D Michos  2 , Kieren A Marr  2 , Andrew H Karaba  2 , Matthew L Robinson  2 , Paul W Blair  2   3 , Maria V Dioverti  2 , Wendy S Post  2 , Andrea L Cox  2 , Annukka A R Antar  2
Affiliations
Review

High-value laboratory testing for hospitalized COVID-19 patients: a review

Daniela Cihakova et al. Future Virol. 2021 Sep.

Abstract

We present here an evidence-based review of the utility, timing, and indications for laboratory test use in the domains of inflammation, cardiology, hematology, nephrology and co-infection for clinicians managing the care of hospitalized COVID-19 patients. Levels of IL-6, CRP, absolute lymphocyte count, neutrophils and neutrophil-to-lymphocyte ratio obtained upon admission may help predict the severity of COVID-19. Elevated LDH, ferritin, AST, and d-dimer are associated with severe illness and mortality. Elevated cardiac troponin at hospital admission can alert clinicians to patients at risk for cardiac complications. Elevated proBNP may help distinguish a cardiac complication from noncardiac etiologies. Evaluation for co-infection is typically unnecessary in nonsevere cases but is essential in severe COVID-19, intensive care unit patients, and immunocompromised patients.

Keywords: COVID-19; CRP; IL-6; SARS-CoV-2; d-dimer; high value care; inpatient; laboratory test; labs; troponin.

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Conflict of interest statement

Financial & competing interests disclosure KA Marr is a consultant and/or advisor for Amplyx, Cidara, Merck and Sfunga and receives equity and/or licensing revenue from MycoMed Technologies. MB Streiff reports research funding from The Patient-Centered Outcomes Research Institute, the Agency for Healthcare Research and Quality, Boehringer-Ingelheim, Janssen, Portola and Roche. MB Streiff has also consulted for Bristol Myers Squibb, Dispersol, Janssen, Pfizer and Portola and has given expert witness testimony in various medical malpractice cases. AAR Antar receives research funding from NIAID-NIH (K08 award) that was not specifically given for the writing of this review article. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

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