Follow-up Article: Chemical Laboratory Changes for COVID-19 Patients

| Covid-19 - Volver al resumen

Following on from our previous article on the significance of coagulation studies in COVID-19 diseases, this overview is intended to take a closer look at the applicability of Greiner Bio-One VACUETTE® tubes in chemical laboratory testing. The progression of COVID-19 disease in patients varies greatly, meaning that there are some with confirmed Coronavirus who have only very mild symptoms (approx. 80%), while others experience or die from an extremely severe (10-15%), even critical (2-5%) progression [1].

Real time RT-PCR tests of, for example, nose and throat swabs are performed using direct virus detection to diagnose COVID-19. Antibody tests for IgG and IgM in the blood show a corresponding immune response from the body after suffering from the disease (an RT-PCR test cannot detect if a person has become ill and recovered). Some studies are available, but the sensitivity and specificity of the individual test methods in particular are a matter for debate [2-5].

Numerous studies have been carried out in the meantime, which included patients with pneumonia and other frequently occurring chronic diseases such as diabetes, hypertension or cardiovascular systemic diseases, and which for the most part highlighted various clinical abnormalities such as fever, cough, and breathing difficulties, muscle, head and chest pain, throat inflammation, mental confusion, rhinorrhoea, diarrhoeal diseases and nausea [6;7;8].

Further chemical laboratory studies also point to COVID-19 disease. Analyses of blood imaging tests and of a comprehensive metabolic panel in the blood serum, for example inflammatory markers such as CRP, procalcitonin, and similarly LDH, ferritin, CK, CK-MB, troponin, aminotransferases, and proinflammatory cytokines, show significant changes in these indicators in patients with COVID-19 disease.

A study [9] found essential analytes for the progressive intensity of COVID-19, such as the number of lymphocytes or neutrophils, albumin, LDH, aminotransferase, cardiac markers, inflammatory markers, and D-dimers. Lymphopenia was confirmed at 35-75%, as was an increase in CRP of 75-93%, LDH of 27-92%, an RBC sedimentation rate of up to 85%, and D-dimer of 36-43%. Lower levels were found for albumin of 50-98% and haemoglobin of 41-50%.

VACUETTE® blood collection tubes

Various VACUETTE® blood collection tubes are available for chemical laboratory testing, in which the biochemical markers listed above have been examined. Correspondingly documented studies can be provided.

VACUETTE® Lithium Heparin Separator Tube (e.g. ref. 456087)
VACUETTE® Serum Sep Clot Activator (e.g. Ref. 456073)
VACUETTE® CAT Serum Fast Separator (e.g. ref. 456310)
VACUETTE® ESR Racks (e.g. ref. 729093, 729073, 729090, 729070)
VACUETTE® SECONDARY Tubes (e.g. ref. 1991 to 1995)

VACUETTE® blood collection tubes bear the CE marking (European Community) and are approved by the FDA (Food and Drug Administration – United States of America). Greiner Bio-One is ISO 9001 and ISO 13485 certified and complies with Good Manufacturing Practice as required by the Brazilian health regulatory authority ANVISA.

References

World Health Organization. Coronavirus disease 2019 (COVID 19) Situation Report -44. Available at www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
[2] Mahase E. Covid-19: "Unacceptable” that antibody test claims cannot be scrutinized, say experts. BMJ 2020; 369 doi: doi.org/10.1136/bmj.m2000
[3] Lacobucci G. Covid-19: Antibody tests will not be rolled out in the UK until at least May, MPs hear. BMJ 2020; 369 doi: doi.org/10.1136/bmj.m1449
[4] Jin Y, Wang M, Zuo Z, Fan C, Ye F, Cai Z, et al. Diagnostic value and dynamic variance of serum antibody in coronavirus disease 2019. Int J Infect Dis 2020 DOI:10.1016/j.ijid.2020.03.065
[5] Gao H X, Li Y N, Xu Z G, Wang Y L, Wang H B, Cao J F, et al. Detection of serum immunoglobulin M and immunoglobulin G antibodies in 2019-novel coronavirus infected cases from different stages. Chinese Medical Journal 2020;26 DOI:10.1097/CM9.0000000000000820
[6].Huang C, Wang Y, Li X, et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[published correction appears in Lancet. 2020 Jan 30].Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5
[7] Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223): 507-513. doi:10.1016/S0140-6736(20)30211-7
[8] Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalised patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [published online before print, 2020 Feb 7]. JAMA. 2020; e201585. doi:10.1001/jama.2020.1585
[9] Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med.2020 Mar 3.doi: 10.1515/cclm-2020-0198.