Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables
We evaluated simple laboratory variables to discriminate COVID-19 from bacterial pneumonia or influenza and for the prospective grading of COVID-19. Multivariate logistic regression and receiver operating characteristic curve were used to estimate the diagnostic performance of the significant discri...
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| Veröffentlicht in: | Diagnostic microbiology and infectious disease 2021-02, Vol.99 (2), p.115169-115169, Article 115169 |
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| container_title | Diagnostic microbiology and infectious disease |
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| creator | Song, Lin Liang, En-Yu Wang, Hong-Mei Shen, Yan Kang, Chun-Min Xiong, Yu-Juan He, Min Fu, Wen-Jin Ke, Pei-Feng Huang, Xian-Zhang |
| description | We evaluated simple laboratory variables to discriminate COVID-19 from bacterial pneumonia or influenza and for the prospective grading of COVID-19. Multivariate logistic regression and receiver operating characteristic curve were used to estimate the diagnostic performance of the significant discriminating variables. A comparative analysis was performed with different severity. The leukocytosis (P = 0.017) and eosinopenia (P = 0.001) were discriminating variables between COVID-19 and bacterial pneumonia with area under the curve (AUC) of 0.778 and 0.825. Monocytosis (P = 0.003), the decreased lymphocyte-to-monocyte ratio (P |
| doi_str_mv | 10.1016/j.diagmicrobio.2020.115169 |
| format | Article |
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•Laboratory features help differential diagnosis and the grade of COVID-19.•Leukocytosis and eosinopenia discriminate COVID-19 from bacterial pneumonia.•Monocytosis, NLR, and LMR distinguish COVID-19 from influenza.•Age, NLR, SAA, LDH, CD3+ cells, and FDP assist the stratification of COVID-19.</description><identifier>ISSN: 0732-8893</identifier><identifier>EISSN: 1879-0070</identifier><identifier>DOI: 10.1016/j.diagmicrobio.2020.115169</identifier><identifier>PMID: 33202303</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Amyloidogenic Proteins - blood ; Bacterial pneumonia ; Child ; Child, Preschool ; Coronavirus disease 2019 (COVID-19) ; COVID-19 - diagnosis ; Diagnosis, Differential ; Differential diagnosis ; Eosinophilia - pathology ; Female ; Fibrinogen - metabolism ; Humans ; Influenza ; Influenza, Human - diagnosis ; L-Lactate Dehydrogenase - blood ; Leukocytosis - pathology ; Lymphocyte Count ; Male ; Middle Aged ; Monocytes - cytology ; Neutrophils - cytology ; Pneumonia, Bacterial - diagnosis ; Prospective grading ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Virology ; Young Adult</subject><ispartof>Diagnostic microbiology and infectious disease, 2021-02, Vol.99 (2), p.115169-115169, Article 115169</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. All rights reserved.</rights><rights>2020 Elsevier Inc. All rights reserved. 2020 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c487t-f5f813db7f8cc067039421de4591dd958cd0b6e4bb89bd39cde667cb8b1253153</citedby><cites>FETCH-LOGICAL-c487t-f5f813db7f8cc067039421de4591dd958cd0b6e4bb89bd39cde667cb8b1253153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0732889320305460$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33202303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Lin</creatorcontrib><creatorcontrib>Liang, En-Yu</creatorcontrib><creatorcontrib>Wang, Hong-Mei</creatorcontrib><creatorcontrib>Shen, Yan</creatorcontrib><creatorcontrib>Kang, Chun-Min</creatorcontrib><creatorcontrib>Xiong, Yu-Juan</creatorcontrib><creatorcontrib>He, Min</creatorcontrib><creatorcontrib>Fu, Wen-Jin</creatorcontrib><creatorcontrib>Ke, Pei-Feng</creatorcontrib><creatorcontrib>Huang, Xian-Zhang</creatorcontrib><title>Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables</title><title>Diagnostic microbiology and infectious disease</title><addtitle>Diagn Microbiol Infect Dis</addtitle><description>We evaluated simple laboratory variables to discriminate COVID-19 from bacterial pneumonia or influenza and for the prospective grading of COVID-19. Multivariate logistic regression and receiver operating characteristic curve were used to estimate the diagnostic performance of the significant discriminating variables. A comparative analysis was performed with different severity. The leukocytosis (P = 0.017) and eosinopenia (P = 0.001) were discriminating variables between COVID-19 and bacterial pneumonia with area under the curve (AUC) of 0.778 and 0.825. Monocytosis (P = 0.003), the decreased lymphocyte-to-monocyte ratio (P < 0.001), and the increased neutrophil-to-lymphocyte ratio (NLR) (P = 0.028) were predictive of influenza with AUC of 0.723, 0.895, and 0.783, respectively. Serum amyloid protein, lactate dehydrogenase, CD3+ cells, and the fibrinogen degradation products had a good correlation with the severity of COVID-19 graded by age (≥50) and NLR (≥3.13). Simple laboratory variables are helpful for rapid diagnosis on admission and hierarchical management of COVID-19 patients.
•Laboratory features help differential diagnosis and the grade of COVID-19.•Leukocytosis and eosinopenia discriminate COVID-19 from bacterial pneumonia.•Monocytosis, NLR, and LMR distinguish COVID-19 from influenza.•Age, NLR, SAA, LDH, CD3+ cells, and FDP assist the stratification of COVID-19.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Amyloidogenic Proteins - blood</subject><subject>Bacterial pneumonia</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Coronavirus disease 2019 (COVID-19)</subject><subject>COVID-19 - diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Differential diagnosis</subject><subject>Eosinophilia - pathology</subject><subject>Female</subject><subject>Fibrinogen - metabolism</subject><subject>Humans</subject><subject>Influenza</subject><subject>Influenza, Human - diagnosis</subject><subject>L-Lactate Dehydrogenase - blood</subject><subject>Leukocytosis - pathology</subject><subject>Lymphocyte Count</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monocytes - cytology</subject><subject>Neutrophils - cytology</subject><subject>Pneumonia, Bacterial - diagnosis</subject><subject>Prospective grading</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Severity of Illness Index</subject><subject>Virology</subject><subject>Young Adult</subject><issn>0732-8893</issn><issn>1879-0070</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU9v1DAQxS0EokvhKyCLE5csdpzENgcktMufSpV6Aa6WY0-ys0rixc5u1SPfHIctVblxsux5896Mf4S84WzNGW_e7dcebT-ii6HFsC5ZmQu85o1-QlZcSV0wJtlTsmJSlIVSWlyQFyntGeOlrthzciFEbhJMrMivLXYdRJhmtANdfKeQMFE7eXqIIR3AzXgC2kfrcepp6Ojm5sfVtuCa2pnOO6Bg43BH02x7oLc472jC8TAA3cFo5zCEHl22XgzztC6__rmfbETbDpBekmedHRK8uj8vyffPn75tvhbXN1-uNh-vC1cpORdd3SkufCs75RxrJBO6KrmHqtbce10r51nbQNW2SrdeaOehaaRrVcvLWvBaXJIPZ9_DsR3Bu7xytIM5RBxtvDPBovm3MuHO9OFkZC1lWels8PbeIIafR0izGTE5GAY7QTgmU1YNV7XWbMl6f5ZmRClF6B5iODMLQ7M3jxmahaE5M8zNrx8P-tD6F1oWbM8CyN91QogmOYTJgceYcRkf8H9yfgPAqrdz</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Song, Lin</creator><creator>Liang, En-Yu</creator><creator>Wang, Hong-Mei</creator><creator>Shen, Yan</creator><creator>Kang, Chun-Min</creator><creator>Xiong, Yu-Juan</creator><creator>He, Min</creator><creator>Fu, Wen-Jin</creator><creator>Ke, Pei-Feng</creator><creator>Huang, Xian-Zhang</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210201</creationdate><title>Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables</title><author>Song, Lin ; Liang, En-Yu ; Wang, Hong-Mei ; Shen, Yan ; Kang, Chun-Min ; Xiong, Yu-Juan ; He, Min ; Fu, Wen-Jin ; Ke, Pei-Feng ; Huang, Xian-Zhang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-f5f813db7f8cc067039421de4591dd958cd0b6e4bb89bd39cde667cb8b1253153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Amyloidogenic Proteins - blood</topic><topic>Bacterial pneumonia</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Coronavirus disease 2019 (COVID-19)</topic><topic>COVID-19 - diagnosis</topic><topic>Diagnosis, Differential</topic><topic>Differential diagnosis</topic><topic>Eosinophilia - pathology</topic><topic>Female</topic><topic>Fibrinogen - metabolism</topic><topic>Humans</topic><topic>Influenza</topic><topic>Influenza, Human - diagnosis</topic><topic>L-Lactate Dehydrogenase - blood</topic><topic>Leukocytosis - pathology</topic><topic>Lymphocyte Count</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monocytes - cytology</topic><topic>Neutrophils - cytology</topic><topic>Pneumonia, Bacterial - diagnosis</topic><topic>Prospective grading</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Severity of Illness Index</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Lin</creatorcontrib><creatorcontrib>Liang, En-Yu</creatorcontrib><creatorcontrib>Wang, Hong-Mei</creatorcontrib><creatorcontrib>Shen, Yan</creatorcontrib><creatorcontrib>Kang, Chun-Min</creatorcontrib><creatorcontrib>Xiong, Yu-Juan</creatorcontrib><creatorcontrib>He, Min</creatorcontrib><creatorcontrib>Fu, Wen-Jin</creatorcontrib><creatorcontrib>Ke, Pei-Feng</creatorcontrib><creatorcontrib>Huang, Xian-Zhang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diagnostic microbiology and infectious disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Lin</au><au>Liang, En-Yu</au><au>Wang, Hong-Mei</au><au>Shen, Yan</au><au>Kang, Chun-Min</au><au>Xiong, Yu-Juan</au><au>He, Min</au><au>Fu, Wen-Jin</au><au>Ke, Pei-Feng</au><au>Huang, Xian-Zhang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables</atitle><jtitle>Diagnostic microbiology and infectious disease</jtitle><addtitle>Diagn Microbiol Infect Dis</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>99</volume><issue>2</issue><spage>115169</spage><epage>115169</epage><pages>115169-115169</pages><artnum>115169</artnum><issn>0732-8893</issn><eissn>1879-0070</eissn><abstract>We evaluated simple laboratory variables to discriminate COVID-19 from bacterial pneumonia or influenza and for the prospective grading of COVID-19. Multivariate logistic regression and receiver operating characteristic curve were used to estimate the diagnostic performance of the significant discriminating variables. A comparative analysis was performed with different severity. The leukocytosis (P = 0.017) and eosinopenia (P = 0.001) were discriminating variables between COVID-19 and bacterial pneumonia with area under the curve (AUC) of 0.778 and 0.825. Monocytosis (P = 0.003), the decreased lymphocyte-to-monocyte ratio (P < 0.001), and the increased neutrophil-to-lymphocyte ratio (NLR) (P = 0.028) were predictive of influenza with AUC of 0.723, 0.895, and 0.783, respectively. Serum amyloid protein, lactate dehydrogenase, CD3+ cells, and the fibrinogen degradation products had a good correlation with the severity of COVID-19 graded by age (≥50) and NLR (≥3.13). Simple laboratory variables are helpful for rapid diagnosis on admission and hierarchical management of COVID-19 patients.
•Laboratory features help differential diagnosis and the grade of COVID-19.•Leukocytosis and eosinopenia discriminate COVID-19 from bacterial pneumonia.•Monocytosis, NLR, and LMR distinguish COVID-19 from influenza.•Age, NLR, SAA, LDH, CD3+ cells, and FDP assist the stratification of COVID-19.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33202303</pmid><doi>10.1016/j.diagmicrobio.2020.115169</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diagnostic microbiology and infectious disease, 2021-02, Vol.99 (2), p.115169-115169, Article 115169 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Amyloidogenic Proteins - blood Bacterial pneumonia Child Child, Preschool Coronavirus disease 2019 (COVID-19) COVID-19 - diagnosis Diagnosis, Differential Differential diagnosis Eosinophilia - pathology Female Fibrinogen - metabolism Humans Influenza Influenza, Human - diagnosis L-Lactate Dehydrogenase - blood Leukocytosis - pathology Lymphocyte Count Male Middle Aged Monocytes - cytology Neutrophils - cytology Pneumonia, Bacterial - diagnosis Prospective grading Retrospective Studies SARS-CoV-2 Severity of Illness Index Virology Young Adult |
| title | Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables |
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