Almost Millions cases of COVID-19 have been confirmed worldwide, resulting in large number of deaths. For such a high volume of patients presenting at hospitals and other health care centers, accurate diagnosis and efficient markers for disease severity, therapeutic response, and disease outcome are key. Laboratory test biomarkers can play a useful role here.
These tests are required for monitoring the patient’s health status throughout the course of the disease and are categorised day wise as the illness progresses. These tests are required whether the patient is admitted to hospital or under home care .
High fever, chills , cough, shortness of breath ,diarrhoea, fatigue ,pneumonia . Complications such as heart failure, myocardial infarction, respiratory failure , thromboembolic events - (stroke and limb ischaemia), acute kidney injury , inflammatory syndrome .
Disease can present as acute viral pneumonia, acute lung damage , acute respiratory distress syndrome . The primary infection could be followed by hyperactive immune reaction which seem to underlie the severe manifestations of the disease
Compared to non-ICU patients, ICU patients had higher plasma levels of IL-6, D-dimer and platelets.
Lymphopenia, neutrophilia, elevated serum ALT and AST levels, elevated LDH, CRP, and ferritin levels have been associated with greater disease severity and hospitalization in COVID-19 patients
Elevated ALT, AST, and creatinine seen in severe cases suggests that COVID-19 carries an increased risk of impaired liver and kidney function
Lymphopenia was more common in ICU patients than non-ICU patients
Significantly more patients in the severe group experienced higher CRP and IL-6 levels vs non-severe.
Cardiac troponin, Myoglobin, CRP and IL-6 significantly increased in cases with mortality
Increased CRP and decreased albumin strongly correlated with disease progression
LDH, NC, CRP and platelet count were higher in refractory vs general patients. Refractory patients had more cases of lung abnormalities, suggesting these biomarkers correlate with development of disease
C-reactive protein (CRP), lactate dehydrogenase (LDH), high-sensitivity troponin (hs-Tn), N-terminal pro–B-type natriuretic peptide (NT-proBNP), and D-dimer improve prognostication in patients hospitalized with coronavirus disease 2019 (COVID-19)
The levels of biomarkers may change according to severity of COVID-19 infection. This can be used as an adjunct in clinical practice to guide treatment and admission to ICU. By doing so, it may improve prognosis and minimise the mortality rates
*Additional home collection charges are applicable.
COVID-19 Monitoring Packages are for people who have been contracted COVID-19 infection and want to keep their health parameters in check from the safety and convenience of their home. Covid monitoring profiles have been introduced to stratify patients requiring hospitalization for future individualised treatment strategies for covid 19.
Having been detected with COVID-19 infection, the impact on health of a person is different in different stages. So for those who have contracted the infection , there are 3 packages & can be chosen as per the duration of symptoms –.
The COVID-19 Monitoring Packages include CBC with Neutrophil to lymphocyte ratio, IL6, cardiac troponin, D Dimer, ferritin, CRP, PT, LDH, Albumin, liver enzymes (SGPT), creatinine & ESR. It is recommended to perform these tests as soon as the symptoms of Covid 19 appear or as directed by the physician for initial risk assessment & stratification.
Early identification and timely treatment of COVID-19 patients at enhanced risk of developing critical disease are pivotal to prevent unfavorable clinical outcome and unsustainable burden on the health care system.
CBC Test looks at the different components of the blood, including hemoglobin, red blood cells, white blood cells, and platelets. In covid 19 patients, decreased white blood cells, lymphocytes (assessed by Neutrophil to lymphocyte ratio) and severely reduced platelet count are associated with poor prognosis.
Albumin is the main protein in the blood. Studies have shown that low levels of albumin in Covid 19 patients is associated with unfavorable outcome in COVID‐19.
D-dimer is test done to rule out presence of blood clot. It is a small protein fragment present in the blood after a blood clot is degraded. The level of D-dimer in the blood can significantly rise when there is significant formation and breakdown of clots in the body. Patients with COVID-19 are reported to have a hypercoagulable state i.e increased tendency to produce blood clots
The IFCC Guidelines on COVID-19 strongly suggest D-Dimer testing in patients with COVID-19.
Studies have shown that fourfold increase in D-dimer on admission could effectively predict in-hospital mortality in patients with Covid-19, which indicated D-dimer could be an early and helpful marker to improve management of Covid-19 patients.
PT is a blood test used for evaluating blood clotting, elevated prothrombin time may help diagnose hypercoagulable state
C-Reactive protein & Erythrocyte sedimentation rate rise in response to inflammation. Measurement is useful for the detection and evaluation of infection, tissue injury, inflammatory processes in Covid 19
Interleukin-6(IL-6) Elevated concentrations of interleukin-6 (IL-6) may indicate an ongoing inflammatory response & it is one of the key mediators of inflammation and viral cytokine storm in COVID-19 patients
Sequential measurements of IL-6 in serum or plasma of patients admitted to the ICU showed to be useful in evaluating the severity of SIRS ( Systemic inflammatory response syndrome) ,sepsis and septic shock and to predict the outcome of these, making it useful indicator in COVID patients.
High ferritin levels correlate with severity of COVID 19. It is one of the markers of inflammation. Elevated ferritin levels due to secondary haemophagocytic lymphohistiocytosis and cytokine storm syndrome have been reported in severe COVID-19 patients
PCT is a widely used biomarker to assess the risk of bacterial infection and disease progression & may serve as a valuable tool in identifying COVID 19patients at high risk for bacterial co infection. Few studies have reported positive association of elevated PCT levels with the severity of COVID-19
As per studies, elevated serum levels of lactate dehydrogenase (LDH) are indicative of cytokine mediated tissue damage and release of LDH, which is a predictor of poor outcome.
Cardiac injury biomarkers (Troponin I/T) According to recent studies published, cardiac injury biomarkers were elevated in most of the complicated cases of COVID-19, and their elevation is directly proportional to the worst outcome.
Creatinine is useful in assessing acute kidney injury in Covid as potential long-term outcomes such as microalbuminuria and chronic kidney diseases are known to occur
Increased levels of liver enzymes can mean that liver is at least temporarily damaged. Patients with severe COVID-19 appear to have more frequent signs of liver dysfunction than those with milder disease.
Antibody or serology tests look for antibodies in the blood to determine if the patient had a past infection with the virus that causes COVID-19. It can take 1–3 weeks after the infection for body to produce antibodies.
Day 1 - Day 5 of infection: The COVID Monitor Initial Package measures over 13 parameters that track various components which include CBC with Neutrophil to lymphocyte ratio (NLR), IL6, cardiac troponin, D Dimer, ferritin, CRP, PT, LDH, Albumin, liver enzymes (SGPT), creatinine & ESR. It is recommended to perform these tests as soon as the symptoms of Covid 19 appear for the initial risk assessment & stratification..
Day 5 - Day 10 of infection: The COVID Monitor Maintenance tracks IL6, D-dimer, Ferritin, C-Reactive Protein and CBC with NLR*.For monitoring of the disease activity & progression, the tests can be done anytime from 5th to 10th day after onset of symptoms.
Before Discharge: COVID Monitoring Recovery tracks ten parameters. Ferritin, CRP, CPK, PT, LDH, CBC, creatinine , SGPT albumin & Anti SARS COv2 antibody testing may be performed for a patient recovering from the disease & getting discharged.
The COVID-19 Home Monitoring Package is designed to be very safe and convenient for patients.
Our phlebotomists follow strict Covid-appropriate protocols when visiting your home including wearing masks and regularly sanitising hands, etc. while also visiting to collect samples with prior appointment only at a time convenient to you.
Since our qualified and trained phlebotomists draw the required sample with proficiency & care the sample is processed at NABL accredited laboratories & accurate results are reported by experts at Metropolis , they are trusted by doctors across the country.
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Metropolis has a team of 200 senior pathologists and over 2000 technicians delivering diagnostic solutions in the areas of routine, semi specialty and super specialty domains like Oncology, Neurology, Gynaecology, Nephrology and many more.
We offer a comprehensive range of 4000+ clinical laboratory tests and profiles, which are used for prediction, early detection, diagnostic screening, confirmation and/or monitoring of the disease.
