Laboratory Indicators In Covid-19 And Other Pneumonias: Analysis For Differential Diagnosis And Comparison Of Dynamic Changes During 400-Day Follow-Up

Background: COVID-19 is spreading rapidly all over the world, the patients' symptoms can be easily confused with other pneumonia types. Therefore, it is valuable to seek a laboratory differential diagnostic protocol of COVID-19 and other pneumonia types on admission, and to compare the dynamic changes in laboratory indicators during follow-up.Methods: A total of 143 COVID-19, 143 bacterial pneumonia and 145 conventional viral pneumonia patients were included. The model group consisted of 140 COVID-19, 80 bacterial pneumonia and 60 conventional viral pneumonia patients, who were age and sex matched. We established a differential diagnostic model based on the laboratory results of the model group on admission via a nomogram, which was validated in an external validation group. We also compared the 400-day dynamic changes of the laboratory indicators among groups.Results: LASSO regression and multivariate logistic regression showed that eosinophils (Eos), total protein (TP), prealbumin (PA), potassium (K), high-density lipoprotein cholesterol (HDLC), and low-density lipoprotein cholesterol (LDLC) could differentiate COVID-19 from other pneumonia types. The C-index of the nomogram model was 0.922. Applying the nomogram to the external validation group showed an area under the curve (AUC) of 0.902. The 400-day change trends of the laboratory indexes varied among subgroups divided by sex, age, oxygenation index (OI), and pathogen.Conclusion: The laboratory model was highly accurate at providing a new method to identify COVID-19 in pneumonia patients. The 400-day dynamic changes in laboratory indicators revealed that the recovery time of COVID-19 patients was not longer than that of other pneumonia types. (C) 2021 The Authors. Published by Elsevier B.V. on behalf of Research Network of Computational and Structural Biotechnology.