Longitudinal analysis of laboratory findings during the process of recovery for patients with COVID-19

ObjectiveTo explore longitudinal change patterns of key laboratory tests in patients with COVID-19, and to identify independent prognostic factors by examining the associations between laboratory findings and outcomes of patients. MethodsThe multicenter study prospectively included 59 patients with COVID-19 treated at Jilin province from January 21, 2020 to May 5, 2020. Laboratory tests were included haematological, biochemical, and immunological tests. ResultsLaboratory findings, the characteristics of epidemiological and demographic data were extracted from electronic medical records. Eosinopenia was shown in 52.6% cases at onset, and the average value of eosinophil continued to significantly increase thereafter. Lymphopenia was found in 40.4% cases at onset, and the average value of lymphocyte was slowly elevated after day 5. Thrombocytopenia was shown in 12.3% cases at onset, and the average value of mean platelet volume was decreased sharply after day 7. The values of aspartate aminotransferase, lactate dehydrogenase, creatine kinase, creatinine kinase-muscle/brain activity, and cardiac troponin I, serum cardiac markers, were beyond the upper limit of RI from 6.1% to 30.6% at onset. The abnormity of liver function tests, kidney function tests, electrolytes was 2.0%[~]59.2%, 2.0%[~]4.1%, 6.0%[~]30.0%, respectively. Eosinophil, platelet and carbondioxide combining power were selected as the prognostic factors. ConclusionsThe haematological, biochemical, and immunological tests were found significant abnormity at onset and longitudinal change patterns in the patients with COVID-19. Age, Eosinophil, PLT and CO2 may used to predict the recovery probability. Risk stratification and management could be improved for the patients with COVID-19 according to temporal trajectories of laboratory tests. Article SummaryThe longitudinal change patterns of the laboratory characteristics of affected patients were important to identify prognosis. Eosinophil, platelet and carbondioxide combining power may be independent predictors of recovery in patients with COVID-19.

Validation of applicability of reference intervals for serum alpha-fetoprotein and carcinoembryonic antigen for adults in Changchun, China / 临床肝胆病杂志

ObjectiveTo investigate whether the reference intervals for serum alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in WS/T 645.2-2018 are applicable to the adults in Changchun, China. MethodsAccording to the validation method for the reference intervals in WS/T 645.2-2018, 5420 subjects, aged from 20-79 years, who underwent physical examination from January 2016 to April 2019 were enrolled and divided into 12 subgroups based on age and sex. Each subgroup was analyzed in terms of whether more than 90% of the measured values fell into the reference intervals, and the changing trend of AFP and CEA with age and sex was analyzed. The Mann-Whitney U test was used for comparison between two groups. ResultsMore than 90% of the measured values of serum AFP and CEA fell into the reference intervals, which passed the validation test. There was a significant difference in serum AFP between male and female subjects aged 30-39 years (Z=-4.51, P＜0.05), and there was a significant difference in serum CEA between male and female subjects aged 20-29, 30-39, 40-49, 50-59, and 60-69 years (Z=-13.45, -18.15, -17.34, -10.82, and -3.65, all P＜0.05). Serum AFP increased slowly with age in female subjects aged 20-69 years and decreased with age in male and female subjects aged 70-79 years. Serum CEA increased with age in male and female subjects aged 20-79 years, and male subjects had a higher measured value than female subjects. ConclusionReference intervals for serum AFP and CEA in WS/T 645.2-2018 issued by National Health Commission are applicable to the adults in Changchun.

Establishing reference intervals of thyroid hormone based on a laboratory information system / 中华内科杂志

Objective:To establish reference intervals (RIs) of thyroid hormone based on data from healthy subjects in laboratory information system (LIS) by indirect methods.Methods:Data were selected from the physical examination center in LIS of the First Hospital of Jilin University from May 2014 to December 2018. The normal distribution of the original data was checked by the Kolmogorov-Smirnov test. Skewed data were transformed into normal distribution using BOX-COX techniques, and outliers were identified by the Turkey method. The continuous percentile curve was established by coefficient of skewness-median-coefficient of variation(LMS) methods. Cut-off value of age was determined by decision trees, and the differences between groups were verified by Z-tests. P2.5 and P97.5 in the RIs were analyzed by non-parametric methods. Results:A total of 45 742 subjects were included in the study. There were no differences in the RI for thyroid stimulating hormone (TSH) among age groups or between men and women ( Z<Z*), and the RI was 0.60-4.41mIU/L (20-79 years old). However, the levels of free triiodothyronine(FT 3) decreased with age in males and females under 35-year-old. The RIs for FT 3 were 4.47-6.44pmol/L (20-44 years old), 4.19-6.21pmol/L (45-64 years old) and 3.90-5.85pmol/L (65-79 years old) in males, and 4.04-6.13pmol/L (20-34 years old) and 3.87-5.76pmol/L (35-79 years old) in females, respectively. The levels of free thyroxine(FT 4) in men were higher than those in women from 20 to 49 years old, and no gender and age differences could be viewed in subjects after 50 years old ( Z<Z*). The RIs for FT 4 were 13.69-21.76pmol/L (male, 20-49 years old), 12.99-20.83pmol/L (female, 20-49 years old) and 12.98-21.21pmol/L (50~79 years old). Conclusion:Establishment of RIs of thyroid hormone based on the data from LIS is simple and reliable, which is suitable for clinical laboratory application.

Establishing reference intervals of thyroid hormone based on a laboratory information system / 中华内科杂志

Objective@#To establish reference intervals (RIs) of thyroid hormone based on data from healthy subjects in laboratory information system (LIS) by indirect methods.@*Methods@#Data were selected from the physical examination center in LIS of the First Hospital of Jilin University from May 2014 to December 2018. The normal distribution of the original data was checked by the Kolmogorov-Smirnov test. Skewed data were transformed into normal distribution using BOX-COX techniques, and outliers were identified by the Turkey method. The continuous percentile curve was established by coefficient of skewness-median-coefficient of variation(LMS) methods. Cut-off value of age was determined by decision trees, and the differences between groups were verified by Z-tests. P2.5 and P97.5 in the RIs were analyzed by non-parametric methods.@*Results@#A total of 45 742 subjects were included in the study. There were no differences in the RI for thyroid stimulating hormone (TSH) among age groups or between men and women (Z<Z*), and the RI was 0.60-4.41mIU/L (20-79 years old). However, the levels of free triiodothyronine(FT3) decreased with age in males and females under 35-year-old. The RIs for FT3 were 4.47-6.44pmol/L (20-44 years old), 4.19-6.21pmol/L (45-64 years old) and 3.90-5.85pmol/L (65-79 years old) in males, and 4.04-6.13pmol/L (20-34 years old) and 3.87-5.76pmol/L (35-79 years old) in females, respectively. The levels of free thyroxine(FT4) in men were higher than those in women from 20 to 49 years old, and no gender and age differences could be viewed in subjects after 50 years old (Z<Z*). The RIs for FT4 were 13.69-21.76pmol/L (male, 20-49 years old), 12.99-20.83pmol/L (female, 20-49 years old) and 12.98-21.21pmol/L (50~79 years old).@*Conclusion@#Establishment of RIs of thyroid hormone based on the data from LIS is simple and reliable, which is suitable for clinical laboratory application.

Validation of applicability of reference intervals for serum alpha-fetoprotein and carcinoembryonic antigen for adults in Changchun, China / 临床肝胆病杂志

ObjectiveTo investigate whether the reference intervals for serum alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in WS/T 645.2-2018 are applicable to the adults in Changchun, China. MethodsAccording to the validation method for the reference intervals in WS/T 645.2-2018, 5420 subjects, aged from 20-79 years, who underwent physical examination from January 2016 to April 2019 were enrolled and divided into 12 subgroups based on age and sex. Each subgroup was analyzed in terms of whether more than 90% of the measured values fell into the reference intervals, and the changing trend of AFP and CEA with age and sex was analyzed. The Mann-Whitney U test was used for comparison between two groups. ResultsMore than 90% of the measured values of serum AFP and CEA fell into the reference intervals, which passed the validation test. There was a significant difference in serum AFP between male and female subjects aged 30-39 years (Z=-4.51, P＜0.05), and there was a significant difference in serum CEA between male and female subjects aged 20-29, 30-39, 40-49, 50-59, and 60-69 years (Z=-13.45, -18.15, -17.34, -10.82, and -3.65, all P＜0.05). Serum AFP increased slowly with age in female subjects aged 20-69 years and decreased with age in male and female subjects aged 70-79 years. Serum CEA increased with age in male and female subjects aged 20-79 years, and male subjects had a higher measured value than female subjects. ConclusionReference intervals for serum AFP and CEA in WS/T 645.2-2018 issued by National Health Commission are applicable to the adults in Changchun.