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High-value laboratory testing for hospitalized COVID-19 patients: a review

  • Cihakova, Daniela1
  • Streiff, Michael B2
  • Menez, Steven P2
  • Chen, Teresa K2
  • Gilotra, Nisha A2
  • Michos, Erin D2
  • Marr, Kieren A2
  • Karaba, Andrew H2
  • Robinson, Matthew L2
  • Blair, Paul W2, 3
  • Dioverti, Maria V2
  • Post, Wendy S2
  • Cox, Andrea L2
  • R Antar, Annukka A2
  • 1 21287, USA
  • 2 21205, USA
  • 3 20817, USA
Published Article
Future Virology
Future Medicine
Publication Date
Sep 21, 2021
DOI: 10.2217/fvl-2020-0316
PMID: 34567235
PMCID: PMC8457535
PubMed Central
  • Review


Doctors managing the complex care of individuals with COVID-19 need timely evidence to guide which lab tests to send to predict outcomes and prevent and treat COVID-19 complications involving the heart, blood clots, the kidney, and other infections that occur during the hospital course. Several lab tests such as IL-6, CRP and white blood cell subset counts may help predict the severity of COVID-19 during the patient’s hospital course if obtained when the patient first presents to the hospital. Other tests such as LDH, ferritin and AST are also associated with severe illness and mortality but have less evidence for their utility beyond IL-6, CRP and other tests. A test related to blood coagulation, d-dimer, is also associated with COVID-19 severity, and it may be used if the patient is suspected of having a blood clot. Two heart biomarkers – cardiac troponin and proBNP – may help doctors diagnose and manage heart-related complications of COVID-19. Patients in the hospital with COVID-19 may be susceptible to other infections, but testing for these is most useful in patients with severe disease, such as those in the intensive care unit. Specific recommendations for testing for viral, bacterial and fungal infections are presented here. The judicious use of laboratory testing can help identify patients at high risk for severe or critical COVID-19 and aid in prevention, diagnosis and treatment of common COVID-19 complications.

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