Laboratory Examinations of Employees of Muhammadiyah University General Hospital of Malang Infected With COVID-19

Abstract

COVID-19 can symptomatically and asymptomatically affect patients. Asymptomatic cases have become a particular concern for public health in the COVID-19 pandemic. One of the simple tests for COVID-19 is the complete blood count that can predict systemic inflammation and disease severity. The description of laboratory tests in asymptomatic COVID-19 patients is rarely reported. This study aimed to compare the laboratory test results of both symptomatic and asymptomatic COVID-19 employees of the Muhammadiyah University General Hospital of Malang. Data were taken from medical records. Diagnoses of COVID-19 were confirmed by nasopharynx-oropharynx PCR swab. Patient characteristics included age, gender, and values of hemoglobin, leukocytes, neutrophils, lymphocytes, platelets, NLR and CRP from two different groups: symptomatic and asymptomatic infected employees. There were 104 COVID-19 infected employees at the hospital from April 2020 to February 2021. Female infected employees (52.9%) were more numerous male infected employees. Employees aged 21-30 years accounted for 53.84% of the total cases. The numbers of symptomatic and asymptomatic employees were 10 employees (9.6%) and 94 employees (90.4%), respectively. There was a significant difference between the symptomatic and asymptomatic groups in the numbers of lymphocytes (p = 0.03) and CRP (p = 0.046). There were no significant differences in the other laboratory results. Lymphopenia and increased CRP numbers more often occurred in the symptomatic group compared to the asymptomatic group. Therefore, these parameters can be an indicator for predicting disease severity. However, further research is needed with a bigger sample.


Keywords: COVID-19, symptomatic, asymptomatic, Muhammadiyah University General Hospital of Malang

References
[1] Pan Y, Li X, Yang G, Fan J, Tang Y, Zhao J, et al. Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients. J Infect. 2020 Jul;81(1):28–32.


[2] Yuen KS, Ye ZW, Fung SY, Chan CP, Jin DY. SARS-CoV-2 and COVID-19: The most important research questions. Cell Biosci. 2020 Mar;10(1):40.


[3] Alshukry A, Ali H, Ali Y, Al-Taweel T, Abu-Farha M, AbuBaker J, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) patients in Kuwait. PLoS One. 2020 Nov;15(11):0242768.



[4] Ahnach M, Bouanani N, Nejjari S, Bendari M, Doghmi K, El Kettani C. The critical role of complete blood count in the management of patients with covid-Pan African Medical Journal. 2020;35(2):1–https://doi.org/10.11604/pamj.supp.2020.35.2.23764.


[5] Bellelli V, d’Ettorre G, Celani L, Borrazzo C, Ceccarelli G, Venditti M. Clinical significance of lymphocytopenia in patients hospitalized with pneumonia caused by influenza virus. Crit Care. 2019 Oct;23(1):330.


[6] Lee J, Park SS, Kim TY, Lee DG, Kim DW. Lymphopenia as a biological predictor of outcomes in COVID-19 patients: A nationwide cohort study. Cancers (Basel). 2021 Jan;13(3):1–15.


[7] Chowdhury SF, Anwar S. Management of Hemoglobin Disorders During the COVID19 Pandemic. Front Med (Lausanne). 2020 Jun;7( June):306.


[8] Lei S, Yu B. Neutrophil percentage and neutrophil-to-monocyte ratio as independent risk factors in the severity of COVID-19. 2020;1–14.


[9] Wool GD, Miller JL. The Impact of COVID-19 Disease on Platelets and Coagulation. Pathobiology. 2021;88(1):15–27.


[10] Seyoum M, Enawgaw B, Melku M. Human blood platelets and viruses: defense mechanism and role in the removal of viral pathogens. Thromb J. 2018 Jul;16(1):16.


[11] Huang G, Kovalic AJ, Graber CJ. Prognostic value of leukocytosis and lymphopenia for coronavirus disease severity. Emerg Infect Dis. 2020 Aug;26(8):1839–41.


[12] Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. 2020 May;27(5):1451–4.


[13] Jurado-Fasoli L, De-la-O A, Molina-Hidalgo C, Migueles JH, Castillo MJ, AmaroGahete FJ. Exercise training improves sleep quality: A randomized controlled trial. Eur J Clin Invest. 2020 Mar;50(3):e13202.


[14] Lima DA, De França JS, De Sales-neto M, Rodrigues-mascarenhas S. “Neutrophils and COVID-19: The road so far.,” no. January, p. 2020.


[15] Yang J, Wang W, Chen Z, Lu S, Yang F, Bi Z, et al. A vaccine targeting the RBD of the S protein of SARS-CoV-2 induces protective immunity. Nature. 2020 Oct;586(7830):572–7.


[16] Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020 May;18(1):206.