Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Oct 2020
Meta AnalysisLaboratory findings of COVID-19: a systematic review and meta-analysis.
The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. ⋯ A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.
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In patients presenting with a possible subarachnoid haemorrhage (SAH), a negative CT scan of the head does not exclude SAH and further investigations are therefore required. Cerebral angiography identifies aneurysms but does not inform on whether they have ruptured and is resource intensive. Examination of the CSF for blood cannot distinguish between an in-vivo bleed and a traumatic lumbar puncture. ⋯ The most appropriate investigation is spectrophotometry of the CSF for the haemoglobin breakdown products, oxyhaemoglobin and bilirubin. Guidelines for the performance of spectrophotometry and interpretation have been produced, modified and are reviewed here. From 5 years' data involving 2302 scans, 92% did not support the occurrence of SAH, 4% indicated the need for angiography to identify a possible aneurysm, while 4% were equivocal due to the presence of oxyhaemoglobin in sufficient concentrations to interfere with the ability to identify bilirubin reliably.
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Scand. J. Clin. Lab. Invest. · Jan 2004
ReviewPrerequisites for establishing common reference intervals.
Establishment of common reference intervals for homogeneous populations within regions is based on the same basic principles as the IFCC recommendations for individual laboratories, but a few additional prerequisites are needed. Thus, the need for common standardization and traceability during production of the reference values and with the application of the common reference intervals in the laboratories becomes crucial. Furthermore, the external control system must be geared to the purpose, using matrix-correct control materials with concentration values traceable to the same reference methods, and validation of results according to analytical quality specifications designed for the use of common reference intervals. ⋯ Therefore, the strategy and the criteria must be thoroughly described. Arguments for establishing common reference intervals are not needed. On the contrary, lack of such common reference intervals should be explained.