新冠肺炎常规实验室检测的诊断准确性

Pub Date : 2022-06-22 DOI:10.3390/reports5030025
Joshua Davis, Gina S Gilderman
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引用次数: 2

摘要

目标:新冠肺炎肆虐全球医疗系统。PCR检测的可用性和及时结果使急诊科的诊断具有挑战性。因此,我们试图确定常规血清实验室检测是否可以诊断新冠肺炎。方法:回顾性分析2020年3月1日至2020年4月28日期间在宾夕法尼亚州一家学术医院接受新冠肺炎检测的所有患者。记录新冠肺炎PCR检测和实验室检测结果。平均差异用于确定哪些测试显示了显著差异,由于多次观察,使用了p<0.01。符合这些标准的测试具有ROC曲线,并确定了敏感性和特异性。结果:在确定的患者中,553人进行了任何实验室检查。在新冠肺炎阳性患者中,所有显示统计学显著平均差异的测试都较低。其中包括白细胞计数、血小板、中性粒细胞绝对计数、淋巴细胞绝对计数、嗜酸性粒细胞绝对数、碱性磷酸酶、白蛋白、肌钙蛋白T、乳酸、D-DIMER和降钙素原。D-Dimer因仅在新冠肺炎阳性患者中完成四项检测而被排除在外。其余测试的特异性为88–96%,敏感性为5–50%。讨论:没有一项血清实验室检测显示对新冠肺炎敏感。有些测试可能具有适度的特异性,但临床应用有限。未来的研究应侧重于诊断新冠肺炎的检测组合,医疗系统应努力获得快速准确的PCR检测,以诊断新冠肺炎。
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Diagnostic Accuracy of Routine Laboratory Tests for COVID-19
Objectives: COVID-19 has ravaged healthcare systems across the globe. Availability of and timely results for PCR testing have made diagnosis in the Emergency Department challenging. Therefore, we sought to determine if routine serum laboratory tests could be diagnostic of COVID-19. Methods: All patients tested for COVID-19 at an academic hospital in Pennsylvania between 1 March 2020–28 April 2020, were retrospectively analyzed. Results of COVID-19 PCR testing and laboratory tests were recorded. Mean difference was used to determine which tests demonstrated a significant difference, with p < 0.01 used, due to multiple observations. The tests that met these criteria had ROC curves and sensitivity and specificity determined. Results: Of the patients identified, 553 had had any laboratory test. All tests that showed a statistically significant mean difference were lower in COVID-19 positive patients. These included white blood cell count, platelets, absolute neutrophil count, absolute lymphocyte count, absolute eosinophil count, alkaline phosphatase, albumin, troponin T, lactic acid, D-DIMER, and procalcitonin. D-Dimer was excluded for only having four tests completed in COVID-19 positive patients. The remaining tests had a specificity of 88–96%, with a sensitivity of 5–50%. Discussion: No single serum laboratory test demonstrated sensitivity for COVID-19. Some tests might be moderately specific, but this was of limited clinical use. Future research should focus on a combination of tests to diagnose COVID-19, and healthcare systems should work to obtain rapid and accurate PCR tests to diagnose COVID-19.
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