Routine laboratory testing to determine if a patient has COVID-19.

摘要: BACKGROUND: Specific diagnostic tests to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and resulting COVID-19 disease are not always available take time obtain results. Routine laboratory markers such as white blood cell count, measures of anticoagulation, C-reactive protein (CRP) procalcitonin, used assess the clinical status a patient. These may be useful for triage people with potential prioritize them different levels treatment, especially in situations where resources limited. OBJECTIVES: To accuracy routine testing test determine if person has COVID-19. SEARCH METHODS: On 4 May 2020 we undertook electronic searches Cochrane Study Register Living Evidence Database from University Bern, which is updated daily published articles PubMed Embase preprints medRxiv bioRxiv. In addition, checked repositories publications. We did apply any language restrictions. SELECTION CRITERIA: included both case-control designs consecutive series patients that assessed The reference standard could reverse transcriptase polymerase chain reaction (RT-PCR) alone; RT-PCR plus expertise or imaging; repeated several days apart samples; WHO other case definitions; by study authors. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data each study. They also methodological quality studies, using QUADAS-2. 'NLMIXED' procedure SAS 9.4 hierarchical summary receiver operating characteristic (HSROC) meta-analyses four more studies. facilitate interpretation results, meta-analysis estimated sensitivity at points on SROC curve corresponded median interquartile range boundaries specificities MAIN RESULTS: 21 studies this review, including 14,126 56,585 non-COVID-19 total. Studies evaluated total 67 tests. Although were interested diagnotic COVID-19, detection SARS-CoV-2 infection through standard. There was considerable heterogeneity between tests, threshold values settings they applied. For some positive result defined decrease compared normal vaues, an increase, increase have indicated positivity. None had either low risk bias all domains concerns applicability domains. Only three specificity over 50%. were: interleukin-6, lymphocyte count decrease. Blood Eleven 93% 25% (95% CI 8.0% 27%; very low-certainty evidence). 15 lower corresponding sensitivity. Four neutrophil count. Their 93%, 10% 1.0% 56%; 11 percentage (4 studies) 59% 100%) (38%; monocyte 13% 6.0% 26%) (73%; (13 64% 28% 89%) (53%; showed platelets 19% 32%) (88%; Liver function alanine aminotransferase (9 12% 3% 34%) (92%; aspartate (7 29% 17% 45%) (81%) (low-certainty albumin 21% 67%) (66%; bilirubin 3.0% Markers inflammation CRP (14 66% 55% 75%) (44%; procalcitonin (6 1% 19%) (86%; IL-6 (four 73% 36% 93%) (58%) (very Other biomarkers creatine kinase (5 11% 6% (94%) serum creatinine 7% 37%) (91%; lactate dehydrogenase 15% 38%) (72%; AUTHORS' CONCLUSIONS: these give indication about general health specific indicators inflammatory processes, none investigated accurately ruling out their own. done hospitalized populations, future should consider non-hospital evaluate how would perform milder symptoms.