The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19

Abdullah Solmaz; Tuğba Meliha Fatma Ercan; Tuğba Erat; Filiz Solmaz

doi:10.18521/ktd.1034760

Research Article

The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19

Year 2022, Volume: 14 Issue: 1, 152 - 160, 14.03.2022

Abdullah Solmaz Tuğba Meliha Fatma Ercan Tuğba Erat Filiz Solmaz

https://doi.org/10.18521/ktd.1034760

Abstract

Objective: Infectious diseases cause inflammation in the human body and produce numerical and functional changes in peripheral blood cells. Coronavirus disease-19 (COVID-19) is also an infectious disease diagnosed by the Polymerase Chain Reaction (PCR) test. However, PCR testing may not always be available. The aim of this study is to show the effect of numerical and functional changes in blood parameters on the diagnosis of COVID-19 in children.
Method: In this retrospective study, 296 patients and 286 healthy children were included. Nasopharyngeal swabs were collected. The swabs were analyzed by Real-time PCR. Independent-t/Mann-Whitney-U tests were applied; Receiver Operating Characteristic (ROC) curves and logistic regression modelling were evaluated.
Result: Gender and age distributions of the groups were similar (p>0.05). There were significant differences between the two groups in terms of white blood cell (WBC) (p<0.001), neutrophil (p<0.001), thrombocyte (p<0.001), lymphocyte (p<0.001), mean platelet volume (MPV) (p=0.009), lactate dehydrogenase (LDH) (p=0.003), C-reactive protein (CRP) (p<0.001) and aspartate aminotransferase (AST) (p=0.002). It was found in ROC curve analyses, while LDH (p<0.001) and CRP (p<0.001) values were higher in patients, MPV (p=0.03), platelet (p=0.04), and neutrophil (p<0.001) values of them were lower. The best model in logistic regression was the model that included hemoglobin, neutrophil, lymphocyte, thrombocyte, LDH and CRP.
Conclusion: Rapid diagnosis of COVID-19 are crucial for public health. PCR, required for definitive diagnosis, may not always be achieved, so easier and cheaper methods are needed. This study supports the diagnosis of COVID-19 in the children in the absence of PCR.

Keywords

COVID-19, child, laboratory parameters, diagnosis

Supporting Institution

Project Number

References

1. Jiatong S, Wenjun L. Epidemiological characteristics and prevention and control measures of Corona Virus Disease 2019 in children. J Trop Med. 2020;20(2):153‐6. doi.org/10.1002/jmv.25807
2. Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ. Novel coronavirus infection in hospitalized infants under 1 year of age in China. Jama. 2020;323(13):1313-4. doi: 10.1001/jama.2020.2131
3. Kemelbekov K, Ospanova E, Baimakhanova B, Zharylkap Z, Klara Z, Zhuldyz Y, et al. Epidemiological characteristics of new coronavirus diseases: Features of risk factors and clinical features of the child population. Electron J Gen Med. 2020;17:252. doi:10.29333/ejgm/8268
4. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID‐19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis. 2020;20:689‐96. doi:10.1016/S1473-3099(20)30198-5
5. Gumus H, Ozcan Y, Kazanasmaz H, Demir A, Guzelcicek A. Clinical Characteristics of COVID-19 Infection in the Pediatric Age Group. Electron J Gen Med. 24;18(5):em308. doi.org/10.29333/ejgm/11019.
6. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2011;140(6):883–99. doi:10.1016/j.cell.2010.01.025
7. An I, Ucmak D. Evaluation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, and C-reactive protein in patients with psoriasis vulgaris. Dicle Med J. 2018;3:327–34. doi:10.5798/dicletip.457261
8. An I, Ucmak D, Ozturk M. Evaluation of neutrophil-to-lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume in patients with lichen planus. Ann Med Res. 2019;26:161–4. doi.org/10.5455/annalsmedres.2018.08.169
9. An I, Ucmak D, Ozturk M, Aksoy M, Yildiz I, Ucan E. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume and C-reactive protein values in psoriatic arthritis patients. Ann Med Res. 2019;26:894–8. doi.org/10.5455/annalsmedres.2019.02.074
10. Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel Coronavirus infection in children: Experts' consensus statement. World J Pediatr. 2020;16:223‐31. doi:10.1007/s12519-020-00343-7
11. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel Coronavirus. World J Pediatr. 2020;16:240‐6. doi:10.1007/s12519-020-00345-5
12. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019‐nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63:364‐74. doi:10.1007/s11427-020-1643-8
13. Xia, W, Shao, J, Guo, Y, Peng, X, Li, Z, Hu, D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 20202;55(5):1169-74. doi:10.1002/ppul.24718
14. Zhang C, Gu J, Chen Q, Deng N, Li J, Huang L, et al. Clinical and epidemiological characteristics of pediatric SARS-CoV-2 infections in China: A multicenter case series. PLOS Med. 2020;17(6):e1003130. doi:10.1371/journal.pmed.1003130
15. Cai J, Xu J, Lin D, Xu L, Qu Z, Zhang Y, et al. A case series of children with 2019 novel coronavirus infection: Clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-51. doi:10.1093/cid/ciaa198
16. Wang D, Ju XL, Xie F, Lu Y, Li FY, Huang HH, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Chinese J Pediatr. 2020;58(4):269-74. doi:10.3760/cma.j.cn112140-20200225-00138
17. Gumus H, Demir A, Yukkaldiran A. Is mean platelet volume a predictive marker for the diagnosis of COVID-19 in children?. Int J Clin Pract. 2020;00:e13892. doi.org/10.1111/ijcp.13892
18. Seyit M, Avci E, Nar R, Senol H, Yilmaz A, Ozen M, et al. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med. 2021;40:110-4. doi:10.1016/j.ajem.2020.11.05
19. Sahin U. COVID-19 sürecinde biyobelirteç olarak laktat dehidrogenaz. COVID19 Sürecinde Biyobelirteçlerin Klinik Pratikte Kullanımı. (Ed Kurt Yüksel M):42-9. Ankara, Türkiye Klinikleri, 2021.
20. Dogan O, Devrim E. Tanı ve İzlemde Laboratuvar Testleri. COVID-19. (Eds O Memikoglu, V Genc):31. Ankara, Ankara Üniversitesi Basımevi, 2020.
21. Kishaba T, Tamaki H, Shimaoka Y, Fukuyama H, Yamashiro S. Staging of acute exacerbation in patients with idiopathic pulmonary fibrosis. Lung. 2014;192:141-9. doi:10.1007/s00408-013-9530-0.
22. Yan L, Zhang H, Goncalves J, Xiao Y, Wang M, Guo Y, et al. An interpretable mortality prediction model for COVID-19 patients. Nat Mach Intell. 2020;2:283-8. doi:10.1038/s42256-020-0180-7.
23. Ghayda RA, Lee J, Lee JY, Kim DK, Lee KH, Hong SH, et al. Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(14):5026. doi:10.3390/ijerph17145026.
24. Ji P, Zhu J, Zhong Z, Li H, Pang J, Li B, et al. Association of elevated inflammatory markers and severe COVID-19: A meta-analysis. Medicine. 2020;99(47):e23315. doi:10.1097/MD.0000000000023315.

COVID-19’lu Çocuklarda PCR Yokluğunda Tanıda Bazı Laboratuvar Parametrelerinin Rolü

Year 2022, Volume: 14 Issue: 1, 152 - 160, 14.03.2022

Abdullah Solmaz Tuğba Meliha Fatma Ercan Tuğba Erat Filiz Solmaz

https://doi.org/10.18521/ktd.1034760

Abstract

Amaç: Enfeksiyon hastalıkları vücutta inflamasyon oluşturarak periferik kan hücrelerinde sayısal ve fonksiyonel değişikliklere neden olur. Coronavirüs hastalığı-19 (COVID-19), Polimeraz Zincir Reaksiyonu (PCR) testinin ile teşhis edilen bulaşıcı bir hastalıktır. Ancak PCR testi her zaman temin edilemeyebilir. Bu çalışmanın amacı, çocklarda kan parametrelerindeki sayısal ve fonksiyonel değişikliklerin PCR olmadığı durumda COVID-19 hızlı teşhisine etkisini değerlendirmektir.
Metod: Çalışmaya 296 COVID-19 hasta ve 286 sağlıklı çocuk dahil edildi. Bilimsel araştırma için gereken izinler alındı. Değişkenlerin normal dağılımına uygunluğuna göre aanalizlerde bağımsız-t veya Mann-Whitney-U testleri uygulandı. Receiver Operating Characteristic (ROC) eğrileri ve lojistik regresyon modellemesi değerlendirildi.
Bulgular: Grupların cinsiyeti ve yaşı benzerdir (p>0.05). Beyaz küre (WBC) (p<0.001), nötrofil (p<0.001), trombosit (p<0.001), lenfosit (p<0.001), ortalama trombosit hacmi (MPV) (p=0.009), laktat dehidrojenaz (LDH) (p=0.003), C-reaktif protein (CRP) (p<0.001) ve aspartat aminotransferaz (AST) (p=0.002) açısından iki grup arasında istatistiksel olarak anlamlı farklılıklar bulunmaktadır. ROC eğrisine bakıldığında, hastalarda LDH (p<0.001) ve CRP (p<0.001) daha yüksekken MPV (p=0.03), platelet (p=0.04), ve nötrofil (p<0.001) sonuçları daha düşüktür. Lojistik regresyonda en iyi model hemoglobin, nötrofil, lenfosit, trombosit, LDH ve CRP'yi içeren modeldi.
Sonuç: COVID-19'un PCR yokluğunda hızlı teşhisi halk sağlığı için çok önemlidir. Kesin tanı için gerekli olan Gerçek Zamanlı Polimeraz Zincir Reaksiyonu (RT-PCR) her zaman sağlanamayabilir, bu nedenle daha kolay ve daha ucuz yöntemlere ihtiyaç vardır. Sınırlı sayıda katılımcıya rağmen bu çalışma çocuklarda labaratuvar parametreleri ile Covid-19'da hızlı tanıyı desteklemektedir.

Keywords

COVİD-19, çocuk, laboratuvar parametreleri

Project Number

References

1. Jiatong S, Wenjun L. Epidemiological characteristics and prevention and control measures of Corona Virus Disease 2019 in children. J Trop Med. 2020;20(2):153‐6. doi.org/10.1002/jmv.25807
2. Wei M, Yuan J, Liu Y, Fu T, Yu X, Zhang ZJ. Novel coronavirus infection in hospitalized infants under 1 year of age in China. Jama. 2020;323(13):1313-4. doi: 10.1001/jama.2020.2131
3. Kemelbekov K, Ospanova E, Baimakhanova B, Zharylkap Z, Klara Z, Zhuldyz Y, et al. Epidemiological characteristics of new coronavirus diseases: Features of risk factors and clinical features of the child population. Electron J Gen Med. 2020;17:252. doi:10.29333/ejgm/8268
4. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID‐19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis. 2020;20:689‐96. doi:10.1016/S1473-3099(20)30198-5
5. Gumus H, Ozcan Y, Kazanasmaz H, Demir A, Guzelcicek A. Clinical Characteristics of COVID-19 Infection in the Pediatric Age Group. Electron J Gen Med. 24;18(5):em308. doi.org/10.29333/ejgm/11019.
6. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2011;140(6):883–99. doi:10.1016/j.cell.2010.01.025
7. An I, Ucmak D. Evaluation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, and C-reactive protein in patients with psoriasis vulgaris. Dicle Med J. 2018;3:327–34. doi:10.5798/dicletip.457261
8. An I, Ucmak D, Ozturk M. Evaluation of neutrophil-to-lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume in patients with lichen planus. Ann Med Res. 2019;26:161–4. doi.org/10.5455/annalsmedres.2018.08.169
9. An I, Ucmak D, Ozturk M, Aksoy M, Yildiz I, Ucan E. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume and C-reactive protein values in psoriatic arthritis patients. Ann Med Res. 2019;26:894–8. doi.org/10.5455/annalsmedres.2019.02.074
10. Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, et al. Diagnosis, treatment, and prevention of 2019 novel Coronavirus infection in children: Experts' consensus statement. World J Pediatr. 2020;16:223‐31. doi:10.1007/s12519-020-00343-7
11. Chen ZM, Fu JF, Shu Q, Chen YH, Hua CZ, Li FB, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel Coronavirus. World J Pediatr. 2020;16:240‐6. doi:10.1007/s12519-020-00345-5
12. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019‐nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63:364‐74. doi:10.1007/s11427-020-1643-8
13. Xia, W, Shao, J, Guo, Y, Peng, X, Li, Z, Hu, D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 20202;55(5):1169-74. doi:10.1002/ppul.24718
14. Zhang C, Gu J, Chen Q, Deng N, Li J, Huang L, et al. Clinical and epidemiological characteristics of pediatric SARS-CoV-2 infections in China: A multicenter case series. PLOS Med. 2020;17(6):e1003130. doi:10.1371/journal.pmed.1003130
15. Cai J, Xu J, Lin D, Xu L, Qu Z, Zhang Y, et al. A case series of children with 2019 novel coronavirus infection: Clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547-51. doi:10.1093/cid/ciaa198
16. Wang D, Ju XL, Xie F, Lu Y, Li FY, Huang HH, et al. Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China. Chinese J Pediatr. 2020;58(4):269-74. doi:10.3760/cma.j.cn112140-20200225-00138
17. Gumus H, Demir A, Yukkaldiran A. Is mean platelet volume a predictive marker for the diagnosis of COVID-19 in children?. Int J Clin Pract. 2020;00:e13892. doi.org/10.1111/ijcp.13892
18. Seyit M, Avci E, Nar R, Senol H, Yilmaz A, Ozen M, et al. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med. 2021;40:110-4. doi:10.1016/j.ajem.2020.11.05
19. Sahin U. COVID-19 sürecinde biyobelirteç olarak laktat dehidrogenaz. COVID19 Sürecinde Biyobelirteçlerin Klinik Pratikte Kullanımı. (Ed Kurt Yüksel M):42-9. Ankara, Türkiye Klinikleri, 2021.
20. Dogan O, Devrim E. Tanı ve İzlemde Laboratuvar Testleri. COVID-19. (Eds O Memikoglu, V Genc):31. Ankara, Ankara Üniversitesi Basımevi, 2020.
21. Kishaba T, Tamaki H, Shimaoka Y, Fukuyama H, Yamashiro S. Staging of acute exacerbation in patients with idiopathic pulmonary fibrosis. Lung. 2014;192:141-9. doi:10.1007/s00408-013-9530-0.
22. Yan L, Zhang H, Goncalves J, Xiao Y, Wang M, Guo Y, et al. An interpretable mortality prediction model for COVID-19 patients. Nat Mach Intell. 2020;2:283-8. doi:10.1038/s42256-020-0180-7.
23. Ghayda RA, Lee J, Lee JY, Kim DK, Lee KH, Hong SH, et al. Correlations of Clinical and Laboratory Characteristics of COVID-19: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(14):5026. doi:10.3390/ijerph17145026.
24. Ji P, Zhu J, Zhong Z, Li H, Pang J, Li B, et al. Association of elevated inflammatory markers and severe COVID-19: A meta-analysis. Medicine. 2020;99(47):e23315. doi:10.1097/MD.0000000000023315.

There are 24 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Articles
Authors	Abdullah Solmaz 0000-0002-9479-8679 Tuğba Meliha Fatma Ercan 0000-0002-1329-2933 Tuğba Erat 0000-0003-2434-4134 Filiz Solmaz 0000-0001-8695-7492
Project Number	-
Publication Date	March 14, 2022
Acceptance Date	March 10, 2022
Published in Issue	Year 2022 Volume: 14 Issue: 1

Cite

APA	Solmaz, A., Ercan, T. M. F., Erat, T., Solmaz, F. (2022). The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19. Konuralp Medical Journal, 14(1), 152-160. https://doi.org/10.18521/ktd.1034760
AMA	Solmaz A, Ercan TMF, Erat T, Solmaz F. The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19. Konuralp Medical Journal. March 2022;14(1):152-160. doi:10.18521/ktd.1034760
Chicago	Solmaz, Abdullah, Tuğba Meliha Fatma Ercan, Tuğba Erat, and Filiz Solmaz. “The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children With COVID-19”. Konuralp Medical Journal 14, no. 1 (March 2022): 152-60. https://doi.org/10.18521/ktd.1034760.
EndNote	Solmaz A, Ercan TMF, Erat T, Solmaz F (March 1, 2022) The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19. Konuralp Medical Journal 14 1 152–160.
IEEE	A. Solmaz, T. M. F. Ercan, T. Erat, and F. Solmaz, “The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19”, Konuralp Medical Journal, vol. 14, no. 1, pp. 152–160, 2022, doi: 10.18521/ktd.1034760.
ISNAD	Solmaz, Abdullah et al. “The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children With COVID-19”. Konuralp Medical Journal 14/1 (March 2022), 152-160. https://doi.org/10.18521/ktd.1034760.
JAMA	Solmaz A, Ercan TMF, Erat T, Solmaz F. The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19. Konuralp Medical Journal. 2022;14:152–160.
MLA	Solmaz, Abdullah et al. “The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children With COVID-19”. Konuralp Medical Journal, vol. 14, no. 1, 2022, pp. 152-60, doi:10.18521/ktd.1034760.
Vancouver	Solmaz A, Ercan TMF, Erat T, Solmaz F. The Role of Some Parameters in Diagnosis in the Absence of PCR in the Children with COVID-19. Konuralp Medical Journal. 2022;14(1):152-60.

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