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Int J Lab Hematol ; 43(1): 116-122, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32812365

RESUMO

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is characterized by a high contagiousness requiring isolation measures. At this time, diagnosis is based on the positivity of specific RT-PCR and/or chest computed tomography scan, which are time-consuming and may delay diagnosis. Complete blood count (CBC) can potentially contribute to the diagnosis of COVID-19. We studied whether the analysis of cellular population data (CPD), provided as part of CBC-Diff analysis by the DxH 800 analyzers (Beckman Coulter), can help to identify SARS-CoV-2 infection. METHODS: Cellular population data of the different leukocyte subpopulations were analyzed in 137 controls, 322 patients with proven COVID-19 (COVID+), and 285 patients for whom investigations were negative for SARS-CoV-2 infection (COVID-). When CPD of COVID+ were different from controls and COVID- patients, we used receiver operating characteristic analysis to test the discriminating capacity of the individual parameters. Using a random forest classifier, we developed the algorithm based on the combination of 4 monocyte CPD to discriminate COVID+ from COVID- patients. This algorithm was tested prospectively in a series of 222 patients referred to the emergency unit. RESULTS: Among the 222 patients, 86 were diagnosed as COVID-19 and 60.5% were correctly identified using the discriminating protocol. Among the 136 COVID- patients, 10.3% were misclassified (specificity 89.7%, sensitivity 60.5%). False negatives were observed mainly in patients with a low inflammatory state whereas false positives were mainly seen in patients with sepsis. CONCLUSION: Consideration of CPD could constitute a first step and potentially aid in the early diagnosis of COVID-19.


Assuntos
Teste para COVID-19 , COVID-19/diagnóstico , Diagnóstico Precoce , Contagem de Leucócitos , Pandemias , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/sangue , COVID-19/diagnóstico por imagem , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Árvores de Decisões , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Leucócitos/classificação , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Aprendizado de Máquina Supervisionado , Tomografia Computadorizada por Raios X , Adulto Jovem
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