Laboratory Abnormalities in Patients with COVID-2019 Infection

Clin Chem Lab Med. 2020 Mar 3. Online ahead of print

Coronavirus disease 2019 (COVID-19), a form of respiratory and systemic zoonosis caused by a virus belonging to the Coronaviridae family, originated from the town of Wuhan in China, is still spreading around the world, thus assuming the dramatic features of a pandemic emergency. According to the recent statistics of the World Health Organization (WHO), the disease has already involved all continents, with over 80,000 diagnosed cases in 34 different countries, and nearly 2700 deaths until February 26, 2020. Despite the severity of COVID-19 seems lower than that of the two previous coronavirus diseases, i.e. SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), the long incubation period and the relatively low pathogenicity compared to that of the two previous homologous viruses are contributing to sustain and amplify the outbreak inside and outside China.

Although the clinical characteristic of COVID-19 have been broadly defined, an outline of the most representative laboratory abnormalities found in patients with COVID-2019 infection is still lacking to the best of our knowledge. It was previously highlighted that laboratory medicine plays an essential role in the early detection, diagnosis and management of many diseases. COVID-2019 makes no exception to this rule, whereby real-time reverse-transcription polymerase chain reaction (rRT-PCR) enables direct virus identification, whilst detection of anti-COVID-19 antibodies by means of fully-automated immunoassays is the mainstay of serological surveillance. Nevertheless, the role of laboratory diagnostics extends far beyond etiological diagnosis and epidemiologic surveillance, whereby in vitro diagnostic tests are commonly used for assessing disease severity, for defining the prognosis, for following-up patients, for guiding treatment and for their therapeutic monitoring. Therefore, the aim of this article is to provide a brief overview on the most frequent laboratory abnormalities encountered in patients with COVID-2019 infection.