Diagnosis of Coronavirus Disease 2019 by Potential Laboratory Factors

Abstract

Objectives: Coronavirus disease 2019 (COVID-19) associated by infection and high death rate. The unresolved questions about the fatality rate of COVID-19 are most probably related to cytokine storm syndrome. There is currently no specific medication. Understanding the pathogenic pathway of this disease will lead to production of treatment and decreases of death rate. The aim of this study is to investigate changes of peripheral blood parameters (Interleukin-6, Ferritin and hematological parameters) in COVID-19 patients, which may be beneficial in the management of patients. Methods: In this comparative study, we collected data of 270 subjects in two groups according RT-PCR test results, including 133 patients with COVID-19 and 137 patients with non-COVID-19, between March 20 and May 21, 2020. After obtaining the ethics code from the ethics committee, the clinical characteristics and laboratory findings of patients were collected from electronic Health Information Systems using data collection forms in Shahid Jalil hospital of Yasuj university of medical sciences. The data were analyzed by SPSS software version 20. Descriptive statistics and chi-square, Mann-Whitney U, Kruskal-Wallis tests and Pearson's correlation coefficient were used to analyse the data. Results: The enrolled COVID-19 patients consisted of 53.4% males and 46.6% females with the medium age of 45.56±18.55 years and there were 50.04% males and 49.6% females with the medium age of 45.59±17.0 years for non COVID-19 patients. There was no significant difference in the age and sex ratio between two populations under study. The proportion interstitial abnormalities evidenced by CT imaging in COVID-19 patients was 91.0%, while, 4.4% abnormalities were found in non-COVID-19 patients. The mean IL-6 and Ferritin levels and hematological parameters in two groups of patients with COVID-19 and non- COVID-19 were significantly different across all comparisons. There was a direct positively correlated between serum level of IL-6, Ferritin levels and hematological parameters including WBC, Lymphocytes, Neutrophils and Hb, except for platelets (negatively correlate), with COVID-19. Conclusion: In conclusion, inflammatory markers specifically IL-6 and Ferritin and hematological parameters (WBC, Lymphocytes, Neutrophils, Platelet and Hb) were correlated with the severity of COVID-19. Measurement of IL-6, Ferritin and hematological indices might be workable tests to diagnosis and prognosis of patients with COVID-19.