The importance of laboratory parameters in predicting the severity of coronavirus disease-19 cases


  • Naim Uzun Department of Clinic Pharmacy, Faculty of Pharmacy, Agri Ibrahim Cecen University, Agri, 04100, Turkey
  • Fatih Birtekocak Department of Medical Biochemistry, Institute of Health Sciences, Aydin Adnan Menderes University, 09100, Efeler, Aydin, Turkey
  • Emrullah Dorman Department of Medical Biochemistry, Institute of Health Sciences, Ataturk University, 25080, Erzurum, Turkey



coagulation parameters, coronavirus, hematological tests, inflammatory parameters


This literature review is aimed at exploring the significance of laboratory parameters in the follow-up of the coronavirus disease-19, which is the latest global biohazard for humanity. Laboratory parameters were classified under three main headings. These headings were hematological tests, inflammatory parameters and coagulation parameters. It has been determined that low lymphocyte count, which is one of the hematological tests, is a condition seen at every stage of the disease. High neutrophil counts are evident in worsening the course of the disease. The neutrophil/lymphocyte ratio increases with increasing disease severity. Low platelet levels may also be observed. It has been determined that high C-reactive protein (CRP) levels can be seen at every stage of the disease. In addition, as the prognosis of the illness worsened, C-reactive protein levels were found to increase more. Increased prothrombin time and high D-dimer values are evident in coagulation tests in patients with severe coronavirus disease-19. In addition, increased ferritin and procalcitonin levels are observed as the illness course worsens. As a result, lymphocytopenia and increased CRP levels come to the fore in the illness course. When the illness becomes more aggressive, prothrombin time, neutrophil/lymphocyte ratio, neutrophil count, D-dimer, ferritin and procalcitonin levels draw attention.


Metrics Loading ...


Download data is not yet available.


A Dasgupta and J L Sepulveda. “Variation, Errors, and Quality in the Clinical Laboratory”. In: Accurate Results in the Clinical Laboratory A Guide to Error Detection and Correction. Ed. by J L Sepulveda. Amsterdam, NL: Elsevier, 2013. DOI: 10.1016/B978-0-12-415783-5.00001-3.

A Keskin et al. “Comparison of laboratory findings and mortality rates of variant alpha and SARS-CoV-2 infected patients”. Int Anatolian Acad Online J Health Sci 7(3) (2021), pp. 79–88.

A Keskin et al. “Homocysteine as a marker for predicting disease severity in patients with COVID-19”. Biomark Med 16(7) (2022), pp. 559–568. DOI: 10.2217/bmm-2021-0688.

A P Yang et al. “The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients”. Int Immunopharmacol 84 (2020), p. 106504. DOI: 10.1016/j.intimp.2020.106504.

A Pourbagheri-Sigaroodi et al. “Laboratory findings in COVID-19 diagnosis and prognosis”. Clin Chim Acta 510 (2020), pp. 475–482. DOI: 10.1016/j.cca.2020.08.019.

Adem Keskin˙ and Recai Aci. “Pre-analytical rejection rates of clinical samples based on patients’ health status”. Baghdad J Biochem Appl Biol Sci 3(01) (2022), pp. 29–39. DOI: 10.47419/bjbabs.v3i01.94.

Adem Keskin˙ et al. “Evaluation of rejection rates and reasons among specimens taken from different hospital units”. Med Lab J 15(6) (2021), pp. 38–43. DOI: 10.29252/mlj.15.6.38.

C Bao, X Tao, W Cui, et al. “SARS-CoV-2 induced thrombocytopenia as an important biomarker significantly correlated with abnormal coagulation function, increased intravascular blood clot risk and mortality in COVID-19 patients”. Exp Hematol Oncol 9 (2020), pp. 16–16. DOI: 10.1186/s40164-020-00172-4.

C Huang, Y Wang, X Li, et al. “Clinical features of patients infected with 2019 novel coronavirus in Wuhan”. Lancet 395 (2020), pp. 497–506. DOI: 10.1016/S0140-6736(20)30183-5.

C Skevaki et al. “Laboratory characteristics of patients infected with the novel SARS-CoV-2 virus”. J Infect 81(2) (2020), pp. 205–212. DOI: 10.1016/j.jinf.2020.06.039.

C Tan, Y Huang, and F Shi. “C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early”. J Med Virol 92(7) (2020), pp. 856–862. DOI: 10.1002/jmv.25871.

D Benvenuto et al. “The 2019-new coronavirus epidemic: Evidence for virus evolution”. J Med Virol 92(4) (2020), pp. 455–459. DOI: 10.1002/jmv.25688.

D Wang, B Hu, C Hu, et al. “Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China”. JAMA 323(11) (2020), pp. 1061–1069. DOI: 10.1001/jama.2020.1585.

D. Bashash, H. Abolghasemi, S. Salari, et al. “Elevation of d-dimer, but not pt and aptt, reflects the progression of covid-19 toward an unfavorable outcome: A meta-analysis”. Iranian J Blood Cancer 12(2) (2020), pp. 47–53.

E Abbasi-Oshaghi et al. “Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings”. Int J Surg 79 (2020), pp. 143–153. DOI: 10.1016/j.ijsu.2020.05.018.

E S Goudouris. “Laboratory diagnosis of COVID-19”. J Pediatr (Rio J) 97(1) (2021), pp. 7–12. DOI: 10.1016/j.jped.2020.08.001.

F A Lagunas-Rangel. “Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis”. J Med Virol 92(10) (2020), pp. 1733–1734. DOI: 10.1002/jmv.25819.

F Zhou, T Yu, and R Du. “Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study”. Lancet 395 (2020), pp. 1054–1062. DOI: 10.1016/S0140-6736(20)30566-3.

G Unluguzel Ustun et al. “Association between Hb A1c and severity of COVID-19 patients”. Hemoglobin 45(2) (2021), pp. 124–128. DOI: 10.1080/03630269.2021.1926278.

H Lu, C W Stratton, and Y W Tang. “The Wuhan SARS-CoV-2-What’s next for China”. J Med Virol 92(6) (2020), pp. 546–547. DOI: 10.1002/jmv.25738.

J Liu, Y Liu, and P Xiang. “Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage”. J Transl Med 18 (2020), pp. 206–206. DOI: 10.1186/s12967-020-02374-0.

K F Kernan and J A Carcillo. “Hyperferritinemia and inflammation”. Int Immunol 29(9) (2017), pp. 401–409. DOI: 10.1093/intimm/dxx031.

L Tan, Q Wang, D Zhang, et al. “Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study [published correction appears in Signal Transduct Target Ther”. Signal Transduct Target Ther 5(1) (2020), pp. 33–33. DOI: 10.1038/s41392-020-0148-4.

Lmf Vieira, E Emery, and A Andriolo. “COVID-19: laboratory diagnosis for clinicians. An updating article”. Sao Paulo Med J 138(3) (2020), pp. 259–266. DOI: 10.1590/1516-3180.2020.0240.14052020.

M Arslanbek Erdem et al. “The relationship between COVID-19 suspected patient’s coagulation and platelet parameters and polymerase chain reaction results”. Konuralp Med J 14(1) (2022), pp. 92–98. DOI: 10.18521/ktd.1009234.

Mukadder Erdem, Adem Keskin, and Recai Aci. “Analysis of sample rejection rates in a training and research hospital biochemistry laboratory”. J Inonu Univ Health Serv Voc Sch 10(1) (2022), pp. 326–334. DOI: 10.33715/inonusaglik.1016798.

N Tang et al. “Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia”. J Thromb Haemost 18(4) (2020), pp. 844–847. DOI: 10.1111/jth.14768.

Q Ruan et al. “Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China [published correction appears in Intensive Care Med”. Intensive Care Med 46(5) (2020), pp. 846–848. DOI: 10.1007/s00134-020-05991-x.

R Aci and A Keskin. “The impact of COVID-19 on some aspects of laboratory activities”. Riv Ital Med Lab 18(2) (2022), pp. 85–90. DOI: 10.23736/S1825-859X.22.00143-8.

R Aci et al. “The relationship between inflammatory indicators and the severity of the disease in coronavirus disease”. Meandros Med Dent J 23(2) (2022), pp. 208–213. DOI: 10.4274/meandros.galenos.2021.65477.

R Aci, A Keskin, and M Ari. “Investigation of laboratory findings, hospitalization day and ex rates of COVID-19 patients with comorbidity”. J Adnan Menderes Univ Health Sci Fac 6(2) (2022), pp. 233–244. DOI: 10.46237/amusbfd.971668.

Rui Hu et al. “Procalcitonin levels in COVID-19 patients”. Int J Antimicrob Agents 56(2) (2020), p. 106051. DOI: 10.1016/j.ijantimicag.2020.106051.

T P Velavan and C G Meyer. “Mild versus severe COVID-19: Laboratory markers”. Int J Infect Dis 95 (2020), pp. 304–307. DOI: 10.1016/j.ijid.2020.04.061.

T Wang, Z Du, F Zhu, et al. “Comorbidities and multi-organ injuries in the treatment of COVID-19”. Lancet 395 (2020), pp. 52–52. DOI: 10.1016/S0140-6736(20)30558-4.

World Health Organization. WHO Coronavirus (COVID-19) Dashboard. 2020. URL: (visited on 08/01/2022).

Y Liu, X Du, J Chen, et al. “Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19”. J Infect 81(1) (2020), pp. 6–12. DOI: 10.1016/j.jinf.2020.04.002.

Z Wu and J M Mcgoogan. “Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the chinese center for disease control and prevention”. JAMA 323(13) (2020), pp. 1239–1242. DOI: 10.1001/jama.2020.2648.

Z Xu, L Shi, Y Wang, et al. “Pathological findings of COVID-19 associated with acute respiratory distress syndrome”. Lancet Respir Med 8(4) (2020), pp. 420–422. DOI: 10.1016/S2213-2600(20)30076-X.




How to Cite

The importance of laboratory parameters in predicting the severity of coronavirus disease-19 cases. (2022). Baghdad Journal of Biochemistry and Applied Biological Sciences, 3(03), 156-165.