High-value laboratory testing for hospitalized COVID-19 patients: a review

Cihakova, Daniela; Streiff, Michael B; Menez, Steven P; Chen, Teresa K; Gilotra, Nisha A; Michos, Erin D; Marr, Kieren A; Karaba, Andrew H; Robinson, Matthew L; Blair, Paul W; Dioverti, Maria V; Post, Wendy S; Cox, Andrea L; R Antar, Annukka A

We present here an evidence-based review of the utility, timing, and indications for laboratory test use in the domains of inflammation, cardiology, hematology, nephrology and co-infection for clinicians managing the care of hospitalized COVID-19 patients. Levels of IL-6, CRP, absolute lymphocyte count, neutrophils and neutrophil-to-lymphocyte ratio obtained upon admission may help predict the severity of COVID-19. Elevated LDH, ferritin, AST, and d-dimer are associated with severe illness and mortality. Elevated cardiac troponin at hospital admission can alert clinicians to patients at risk for cardiac complications. Elevated proBNP may help distinguish a cardiac complication from noncardiac etiologies. Evaluation for co-infection is typically unnecessary in nonsevere cases but is essential in severe COVID-19, intensive care unit patients, and immunocompromised patients.