Parameters associated with diagnosis of COVID-19 in emergency department

Immun Inflamm Dis. 2021 Sep;9(3):851-861. doi: 10.1002/iid3.440. Epub 2021 May 7.

Abstract

Objectives: We designed this study to identify laboratory and radiological parameters, which could be useful to guide the clinician, in the evaluation of a suspected case of coronavirus disease 19 (COVID-19).

Methods: This retrospective, observational, single-center-study recruited patients with a suspect of COVID-19 data were extracted from electronic medical records using a standardized data collection form.

Results: A total of 566 patients with suspect COVID-19 infection were enrolled (280 were COVID-19+). The COVID-19 population was characterized with bilateral-pneumonia, a lower count of neutrophil, lymphocyte and monocyte, a lower neutrophil to lymphocyte-ratio (NLR). Lower of platelet count, d-dimer, troponin I, and serum calcium were in COVID-19 patients. The occurrence of COVID-19 diagnosis increased, independently of other variables, with pneumonia (odds ratio [OR]: 3.60; p < .001), neutrophil below normal range (OR: 4.15; p < .05), lactate dehydrogenase (OR: 2.09; p < .01) and sodium above normal range (OR: 2.34; p < .01). In patients with possible respiratory acute affections we found a higher neutrophil, higher monocyte, a higher NLR and a more elevation in d-dimer. In the Sepsis group showed higher level of white blood cell, C-reactive protein, d-dimer, and procalcitonin.

Conclusions: Our study confirms that patients with COVID-19 have typical radiological and laboratory characteristics. The parameters highlighted in the study can help identify COVID-19 patients, also highlighting which are the main differential diagnoses to be made and the parameters that facilitate the differential diagnosis.

Keywords: ED; SARS-COV2; Sepsis disease; heart failure; respiratory disease.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 Testing*
  • COVID-19* / diagnosis
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies