Mini Review

A Mini Review in Laboratory Findings of Patients with COVID-19

Barbosa da Silva E1,2 * and Camila dos Santos C1

1Department of Pathology, Centro Universitário Saúde ABC, Brazil

2Department of Biomedical Sciences, Ibirapuera University, Brazil

Received Date: 31/07/2020; Published Date: 19/08/2020

*Corresponding author: Emerson Barbosa da Silva, Department of Pathology, Centro Universitário Saúde ABC, Santo André, SP, Brazil. E-mail: emerson.silva@fmabc.br; ORCID ID: https://orcid.org/0000-0003-0953-479X

DOI: 10.46998/IJCMCR.2020.03.000066

Introduction

Coronavirus is a zoonotic virus, RNA virus of the order Nidovirales, of the family Coronaviridae [1]. This is a family of viruses that cause respiratory infections, which were isolated for the first time in 1937 and described as such in 1965, due to their profile under microscopy resembling a crown [2]. The types of coronavirus known to date are: alpha coronavirus HCoV-229E and alpha coronavirus HCoV-NL63, beta coronavirus HCoV-OC43 and beta coronavirus HCoV-HKU1, SARS-CoV (causing severe acute respiratory syndrome or SARS), MERS- CoV (causing Middle East respiratory syndrome or MERS) and SARS-CoV-2, the new coronavirus, described with the first case in December 2019 in Wuhan, Hubei province, and spread very quickly to many provinces in China and other countries [2,3].

A characteristic of SARS-CoV-2, which has contributed to it becoming a worldwide public health problem, is its high transmission rate, which occurs through fomites and respiratory droplets from coughing and / or sneezing. This transmission can happen, depending on the concentration of viral particles in the environment, having been demonstrated viral viability in aerosol dispersion for three hours or more [4-6].

The clinical spectrum of coronavirus infection is very wide, ranging from a simple cold to severe pneumonia. The initial clinical picture of the disease is characterized as a flu-like syndrome. COVID-19 patients usually develop signs and symptoms, including mild breathing problems and persistent fever, on average 5 to 6 days after infection. The fever is usually persistent, in contrast to the decrease observed in cases of influenza [7,8]. Fever may not be present in some cases, for example, in young, elderly, immunosuppressed patients or in some situations that may have used antipyretic medication [8,9]. The disease in children appears to be relatively rare and mild, with cases reported among individuals under 19 years of age [9,10].

High lethality was one of the main characteristics that differentiated SARS and MERS coronavirus outbreaks from the other four species known to cause common cold symptoms [11-13]. In Brazil, on February 26, 2020, the first patient with COVID-19 was diagnosed. A resident of the city of São Paulo who had recently returned from a trip to Italy. Five days after the first case, another positive case is confirmed in the country and in just 11 days the sum of confirmed cases reaches 25 people, currently, in July 2020 there are more than two and a half million cases [14-16]. On March 11, the World Health Organization (WHO) characterized COVID-19 as a pandemic. However, until now, the virus is not fully known and scientific publications on the prognosis, diagnosis and monitoring of patients are also superficial [17]. Thus, a pattern of the most representative laboratory abnormalities found in patients with COVID-2019 infection is missing.

Laboratory diagnosis plays an essential role in the early detection, diagnosis and treatment of many diseases. COVID-2019 is no exception to this rule, in which the polymerase chain reaction with real-time reverse transcription (RT-PCR) allows for the direct identification of the virus [18]. However, the role of laboratory diagnosis goes far beyond etiological diagnosis and epidemiological surveillance, but it also has the function of assessing the severity of the disease, defining the prognosis, monitoring patients, guiding treatment and monitoring their therapy [19-23]. The role of clinical laboratory data in the differential diagnosis of severe forms of COVID - 19 has not yet been established and knowing the prognosis of the disease through hematological, biochemical and immunological statuses is crucial for the timely treatment and increased survival of critically ill patients [24].

References:

1. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report 81. Geneva, Switzerland: World Health Organization; 2020. https://www.who.int/docs/default-source/coronaviruse/situationreports/20200410-sitrep-81-covid-19.pdf?sfvrsn=ca96eb84_2.

2. CUI, Jie, LI, Fang, SHI, Zheng-Li. Origin and evolution of pathogenic coronaviruses. Nature Reviews Microbiology. 2019;17(3):181-192.

3. Guan, Wei-jie et al. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine. 2020;382(18):1708-1720.

4. Brasil. Ministério da Saúde. Protocolo de manejo clínico para o novo-coronavírus (2019 nCoV). Available from: https://portalarquivos2.saude.gov.br/images/pdf/2020/fevereiro/11/protocolo-manejo-coronavirus.pdf.

5. Brasil. Ministério da Saúde. Coronavírus: o que você precisa saber e como prevenir o contágio. Available from: https://saude.gov.br/saude-de-a-z/coronavírus.

6. WEI, Wycliffe E. et al. Presymptomatic Transmission of SARS-CoV-2—Singapore, January 23–March 16, 2020. Morbidity and Mortality Weekly Report. 2020;69(14):411.

7. TIAN, Huaiyu et al. An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China. Science. 2020;368(6491):638-642.

8. LU, Hongzhou, STRATTON, Charles W, TANG, YiWei. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. Journal of medical virology. 2020;92(4):401-402

9. XU, Zhe et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine. 2020;8(4):420-422.

10. Cascella, Marco et al. Features, evaluation and treatment coronavirus (COVID-19). In: Statpearls [internet]. StatPearls Publishing, 2020.

11. Zhan, Mingkun et al. Death from Covid-19 of 23 health care workers in China. New England Journal of Medicine, 2020.

12. Cheng, Yichun et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney international, 2020.

13. Jordan, Rachel E, Adab, Peymane, Cheng KK. Covid-19: risk factors for severe disease and death. 2020.

14. Werneck, Guilherme Loureiro, Carvalho, Marilia Sá. A pandemia de COVID-19 no Brasil: crônica de uma crise sanitária anunciada. 2020.

15. Rodriguez-morales, Alfonso J. et al. COVID-19 in Latin America: The implications of the first confirmed case in Brazil. Travel medicine and infectious disease. 2020.

16. Livingston, Edward, Bucher, Karen. Coronavirus disease 2019 (COVID-19) in Italy. Jama. 2020;323(14):1335-1335.

17. WORLD HEALTH ORGANIZATION. Coronavirus disease 2019 (COVID-19) situation report – 81. Geneva, Switzerland: World Health Organization; 2020. https://www.who.int/docs/default-source/coronaviruse/situationreports/20200410-sitrep-81-covid-19.pdf?sfvrsn=ca96eb84_2.

18. Long, Chunqin et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?. European journal of radiology. 2020;108961.

19. LIPPI, Giuseppe; PLEBANI, Mario. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clinical Chemistry and Laboratory Medicine (CCLM ahead-of-print. 2020.

20. Henry, Brandon Michael et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM). 2020;58(7):1021-1028.

21. Fardet, Laurence et al. Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome. Arthritis & Rheumatology. 2014;66(9):2613-2620.

22. CHEN, Nanshan et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-513.

23. TANG, Yi-Wei et al. Laboratory diagnosis of COVID-19: current issues and challenges. Journal of clinical microbiology. 2020;58(6).

24. Gao Y, Li T, Han M, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791-796. doi:10.1002/jmv.25770.

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