Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
Total Protein as a Biomarker for Predicting Coronavirus Disease-2019 Pneumonia
20 Pages Posted: 13 Mar 2020
More...Abstract
Background: COVID-19 RNA detected by RT-PCR is not sensitive enough to diagnose COVID-19. The purpose of this study was to identify cost‑effective biomarkers for predicting COVID-19 pneumonia.
Methods: This retrospective study examined the records of 28 COVID-19 cases. Apriori algorithm of association rules was employed to identify laboratory indexes related to COVID-19 pneumonia.
Finding: The symptom of COVID-19 was 64.29% fever, 46.43% expectoration, 32.14% dry cough, 14.29% fatigue, 14.29% pharyngalgia, 3.57% myalgia, 3.57% dyspnea. In the first stages of hospitalization, the level of neutrophil, monocyte, MPV, MCHC, NMR, AST, ALT and DBIL were significantly increased, while lymphocyte, eosnophils, basophilic granulocyte, platelet, PDW, MPV, MCV, NLR, total protein (TP), albumin, globulin and uric acid were significantly elevated in COVID-19 pneumonia. Moreover, TP, DBIL, M% and albumin were strongly associated with COVID-19 pneumonia, and TP was identified as an independent risk factor for it. The area under ROC curve of TP was 0.844 and the optimal clinical cutoff level was 72.8g/L, which provided 78.6% sensitivity and 79.3% specificity. Interestingly, TP combined with COVID-19 RNA exhibited 96.4% sensitivity and 0.05 negative likelihood ratios. Importantly, the false negative rate of COVID-19 RNA was 39.3%, and 90.91% of them can be detected by TP. In addition, TP was markedly reduced in patients with COVID-19 pneumonia compared with no-COVID-19 pneumonia and healthy control, and it was significantly decreased in severe and critical of COVID-19 pneumonia than the common stage and mild stage.
Interpretation: Our study suggested that TP may be a biomarker for predicting COVID-19 pneumonia.
Funding Statement: Supported by Gansu Provincial COVID-19 Science and Technology Major Project, China.
Declaration of Interests: The authors have no conflicts of interest to declare.
Ethics Approval Statement: The study protocol was approved by the Research Ethics Committee of the First Hospital of Lanzhou University (No. LDYYLL2020-15), and the informed consent requirement was waived because it was a retrospective study. All the data were collected anonymously and analyzed to facilitate better clinical decisions and treatment.
Keywords: coronavirus disease-2019; total protein; Alpha-hydroxybutyrate dehydrogenase; biomarker
Suggested Citation: Suggested Citation