Inflammatory Markers Are Not Useful for Identifying Patients With SARS-CoV-2 Infection
Journal of the National Medical Association
; 112(5):S15, 2020.
Article
in English
| EMBASE | ID: covidwho-988445
ABSTRACT
Background:
Due to the limited availability of rapid testing for SARS-CoV-2 infection, these tests are often reserved for those requiring urgent procedures or hospital admission and are often not available to emergency department (ED) patients. Complete blood count (CBC), C-reactive protein (CRP) and Ferritin levels can be easily obtained in the ED. Lymphopenia and high C-reactive protein and Ferritin levels are associated with poor outcome in COVID-19 illness. However, it is not known whether these biomarkers are useful for identifying persons with SARS-CoV-2 infection.Methods:
We performed a cross-sectional study of patients 18 years or older who were evaluated at an academic ED for suspected SARS-CoV-2 infection from March to May 2020. CBC, CRP and Ferritin levels were ordered at clinician’s discretion in patients who were suspected to have SARS-CoV-2 infection. SARS-CoV-2 infection was diagnosed using a number of PCR-based tests including the Cepheid Xpert Xpress and the Diasorin Simplexa. The discriminative values of the candidate biomarkers were estimated using the area under the receiver operating characteristic curve (AUC).Results:
We studied a total of 1082 patients who had a median age of 59.5 (IQR 46.0 – 71.0) years. A total of 431 (39.8%) of the subjects had PCR confirmed SARS-CoV-2 infection. The median absolute lymphocyte count was 0.9 (IQR 0.7 – 1.3) and 1.0 (0.7 – 1.6) in those with and those without SARS-CoV-2 infection respectively (p=0.0004). The median CRP level in mg/L was 8.9 (IQR 4.6 – 17.3) and 6.1 (IQR 1.6 – 14.0) in those with and those without SARS-CoV-2 infection respectively (p=0.0001). The median ferritin level in ng/mL was 782 (IQR 299 – 1479) and 312 (IQR 106 – 1015) in those with and those without SARS-CoV-2 infection respectively (p=0.0001). Lymphocyte count, CRP and Ferritin levels distinguished between those with and those without SARS-CoV-2 infection with AUCs of 0.56 (IQR 0.53 – 0.60), 0.61 (IQR 0.58 – 0.64) and 0.66 (IQR 0.62 – 0.68).Conclusion:
Although patients with SARS-CoV-2 infection have lymphopenia and elevated CRP and ferritin levels, the levels of these biomarkers are not useful for identifying persons under investigation who have SARS-CoV-2 infection.
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of the National Medical Association
Year:
2020
Document Type:
Article
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