1. Clinical laboratory evaluation of COVID-19
- Author
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Li Zhang, Shuomin Li, Zhufeng Chen, Wanju Xu, Ma Wanshan, Hao Mingju, Yuanxun Fang, and Shi Xiaohong
- Subjects
Review ,Disease ,TNF-α, tumor necrosis factor-α ,Biochemistry ,US, United States ,IL-1β, interleukin 1β ,PCR, polymerase chain reaction ,0302 clinical medicine ,Ang I, angiotensin I ,DIC, disseminated intravascular coagulation ,COVID-19, coronavirus disease 2019 ,LDH, lactate dehydrogenase ,General Medicine ,Clinical Laboratory Services ,CSS, cytokine storm syndrome ,NAAT, nucleic acid amplification testing ,RT-LAMP, reverse transcription loop-mediated isothermal amplification ,030220 oncology & carcinogenesis ,CRP, C-reactive protein ,G-CSF, granulocyte-colony stimulating factor ,Viral load ,WBC, white blood cell ,IgG, immunoglobulin G ,ACE2, angiotensin-converting enzyme 2 ,MCP1, monocyte chemoattractant protein 1 ,03 medical and health sciences ,RT-PCR, reverse transcription polymerase chain reaction ,POCT, point-of-care tests ,PT, prothrombin time ,Humans ,Serologic Tests ,RdRp, RNA-dependent RNA polymerase ,Risk factor ,APTT, activated partial thromboplastin time ,ARDS, acute respiratory distress syndrome ,IL-2R, interleukin 2R ,Aged ,Ang II, angiotensin II ,LOD, limit of detection ,LRT, lower respiratory tract ,Ag-RDT, Antigen-detecting rapid diagnostic test ,Biomarker ,MIP-1α, macrophage inflammatory protein-1α ,medicine.disease ,SAA, serum amyloid A protein ,030104 developmental biology ,Infectious disease (medical specialty) ,Laboratory diagnosis ,Immunology ,0301 basic medicine ,PLRs, platelet-to-lymphocyte ratios ,Clinical Biochemistry ,AST, aspartate aminotransferase ,IFN-γ, interferon γ ,MERS-CoV, middle east respiratory syndrome coronavirus ,CLIA, chemiluminescence-immunoassay ,MasR, Mas receptor ,TRAIL, TNF related apoptosis inducing ligand ,Respiratory disease ,BLF, bronchoalveolar lavage fluid ,ELISA, enzyme-linked immunosorbent assay ,ICU, intensive care unit ,VEGF, vascular endothelial growth factor ,PCT, procalcitonin ,FDA, food and drug administration’s ,IL-6, interleukin 6 ,RBD, receptor binding domains ,IP10, induced protein 10 ,WHO, world health organization ,NLR, neutrophil–lymphocyte ratio ,Biomarker (medicine) ,ORF, open-reading frames ,medicine.symptom ,IL-7, interleukin 7 ,ACE, angiotensin-converting enzyme ,SARS-CoV, severe acute respiratory syndrome coronavirus ,Inflammation ,IgA, immunoglobulin A ,AT2R, AT2 receptor ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,EUA, emergency use authorization ,ALT, alanine aminotransferase ,Diabetes mellitus ,qRT-PCR, real-time quantitative reverse transcription polymerase chain reaction ,IFN-α, interferon α ,medicine ,FDP, fibrinogen and fibrin degradation products ,TMPRSS2, transmembrane protease serine type 2 ,SARS-CoV-2 ,business.industry ,Biochemistry (medical) ,COVID-19 ,RAS, renin-angiotensin system ,IgM, immunoglobulin M ,PE, pulmonary embolism ,IL-2, interleukin 2 ,IL-10, interleukin 10 ,Laboratories ,business ,CK, creatine kinase - Abstract
COVID-19, caused by SARS-CoV-2, is a highly infectious disease, and clinical laboratory detection has played important roles in its diagnosis and in evaluating progression of the disease. Nucleic acid amplification testing or gene sequencing can serve as pathogenic evidence of COVID-19 diagnosing for clinically suspected cases, and dynamic monitoring of specific antibodies (IgM, IgA, and IgG) is an effective complement for false-negative detection of SARS-CoV-2 nucleic acid. Antigen tests to identify SARS-CoV-2 are recommended in the first week of infection, which is associated with high viral loads. Additionally, many clinical laboratory indicators are abnormal as the disease evolves. For example, from moderate to severe and critical cases, leukocytes, neutrophils, and the neutrophil-lymphocyte ratio increase; conversely, lymphocytes decrease progressively but are over activated. LDH, AST, ALT, CK, high-sensitivity troponin I, and urea also increase progressively, and increased D-dimer is an indicator of severe disease and an independent risk factor for death. Severe infection leads to aggravation of inflammation. Inflammatory biomarkers and cytokines, such as CRP, SAA, ferritin, IL-6, and TNF-α, increase gradually. High-risk COVID-19 patients with severe disease, such as the elderly and those with underlying diseases (cardiovascular disease, diabetes, chronic respiratory disease, hypertension, obesity, and cancer), should be monitored dynamically, which will be helpful as an early warning of serious diseases.
- Published
- 2021
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