Diagnostic Value of Hematological and Biochemical Parameters Combinations for Predicting Coronavirus Disease 2019 (COVID-19) in Suspected Patients

BACKGROUND: The severe epidemiologic situation of COVID-19 due to the limited capacity of healthcare systems makes it necessary to improve the hospital management and early identification and stratification of patients. The aim of the study was to explore hematological and biochemical parameters at admission to the hospital as novel early predictors for diagnosis with coronavirus disease 2019 (COVID-19) among all suspected patients. METHODS: This was a retrospective, multicenter, observational study. The clinical data of all suspected patients were analyzed. The suspected patients with negative RT-PCR results were included as the control group, and compared with confirmed patients. Receiver- operating characteristic (ROC) curves and logistic regression analyses were used to evaluate the hematological indexes. RESULTS: In total, 326 confirmed COVID-19 patients and 116 control patients were included. The predictive ability of combinations of the hematological and biochemical parameters was significantly superior to that of a single parameter. The area under the ROC curve (AUC) of the aspartate aminotransferase (AST) to neutrophil ratio index (ANRI) and the AST to monocyte ratio index (AMRI) were 0.791 and 0.812, respectively. In the multivariate analysis, an ANRI ≥ 6.03(OR: 3.26, 95% CI: 1.02-10.40, P=0.046) and an AMRI ≥ 36.32(OR: 3.64. 95% CI: 1.24-10.68, P=0.02) at admission were independent risk factors related to the occurrence of COVID-19. CONCLUSIONS: We found two novel predictors with promising predictive capacities for COVID-19 among all suspected patients: ANRI and AMRI. Our findings need to be confirmed in further studies.