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COVID Risk Monitoring Testing

COVID-19 Risk Monitoring Test
Information and Resources

Labcorp offers several profiles to aid in the assessment and management of COVID-19-related illness. These comprehensive profiles allow for faster and easier ordering of important tests.

Test Code Test Name Use Test Components

164044

COVID-19 Induced Thrombotic Microangiopathy Profile

Assessment of patients at high risk of COVID-19-associated thrombotic microangiopathy. It has been reported that increased levels of LDH, D-Dimer, von Willebrand Antigen, and Factor VIII Activity are significantly associated with severe illness.1,2 Decreased levels of Total Complement (CH50), and ADAMTS13 Activity, and increased von Willebrand Antigen were associated with the risk of microthrombosis and Thrombotic Microangiopathy.2,3,4  
  • ADAMTS13 Activity
  • Complement, Total (CH50)
  • D-Dimer
  • Factor VIII Activity
  • Lactic Acid Dehydrogenase (LDH)
  • von Willebrand Antigen

164049

COVID-19 Severe Disease Progression Risk Profile

Comprehensive panel for the assessment of patients at risk of severe COVID-19 disease progression. Increased levels of the markers in this profile are associated with a higher risk of progression to severe COVID-19. NLR of less than 3.0 is reported to be associated with clinical improvement in COVID-19 patients5, while CRP below 20 mg/L is associated with non-severe COVID-19 disease.6 Elevated levels of D-Dimer and IL-6 greater than 24 pg/mL is associated with severe disease progression and high sensitivity and specificity for early prediction of severity of COVID-19.7 NLR above 4.9 is reported to be significantly associated with risk of intubation.8,9 Elevated levels of LDH, ferritin, and NT-proBNP are reported to be associated with severe COVID-19.10,11,12 CRP greater than 26 mg/L and PCT greater than 2.0 ng/mL are reported to be associated with risk of severe disease progression.10,11,12
  • C-Reactive Protein (CRP), Quantitative
  • D-Dimer
  • Ferritin, Serum
  • Interleukin-6 (IL-6), Serum
  • Lactic Acid Dehydrogenase (LDH)
  • Neutrophil to Lymphocyte Ratio (NLR)
  • NT-proBNP
  • Procalcitonin (PCT)

164052

COVID-19 Triage Profile

Assessment of patients at risk of progression to severe COVID-19 within 7 days from admission.13  NLR of less than 3.0 is reported to be associated with clinical improvement in COVID-19 patients5 while CRP below 20 mg/L is associated with non-severe COVID-19 disease.6 Elevated levels of D-Dimer, NLR greater than 4.6, and CRP greater than 26 mg/L were reported to be associated with risk of severe disease.9,10,11,12 These markers can assist in triaging patients at the time of admission.13
  • C-Reactive Protein (CRP), Quantitative
  • D-Dimer
  • Neutrophil to Lymphocyte Ratio (NLR)

164081

COVID-19 Poor Outcomes Risk Profile

Assessment of patients at risk of mortality from COVID-19 disease. Increased levels of the markers in this profile are associated with a higher risk of progression to severe COVID-19. Elevated levels of D-Dimer, LDH, ferritin, and NLR above 4.9 are reported to predict risk of poor outcomes of COVID-19.8,9,10,11,12
  • D-Dimer
  • Ferritin, Serum
  • Lactic Acid Dehydrogenase (LDH)
  • Neutrophil to Lymphocyte Ratio (NLR)

165039

Post-COVID 19 Fatigue Evaluation

Subacute fatigue is defined as lasting between one and six months, and chronic fatigue as lasting more than six months. Fatigue that is greater than one- month duration may be due to an underlying chronic medical or psychological condition. Medication toxicity or substance use should also be considered. Common underlying conditions that may present as chronic fatigue include anemia, chronic renal disease, chronic liver disease, hypercalcemia, hyponatremia, hypothyroidism, diabetes, heart disease, depression, and obesity. The tests in the profile were selected to support Limited testing in patients suffering subacute or chronic fatigue to rule out an underlying medical condition.14,15,16
  • CBC (with Differential) 
  • TSH (µIU/mL)
  • AST (IU/L)
  • ALT (IU/L)
  • Albumin (pg/mL)
  • Creatinine (mg/dL)
  • BUN (mg/dL)
  • Sodium (mmol/L)
  • Calcium (mg/dL)
  • HbA1C (%)

Test Number: 164044

COVID-19 Induced Thrombotic Microangiopathy Profile

Use:
Assessment of patients at high risk of COVID-19-associated thrombotic microangiopathy. It has been reported that increased levels of LDH, D-Dimer, von Willebrand Antigen, and Factor VIII Activity are significantly associated with severe illness.1,2 Decreased levels of Total Complement (CH50), and ADAMTS13 Activity, and increased von Willebrand Antigen were associated with the risk of microthrombosis and Thrombotic Microangiopathy.2,3,4  

Components

  • ADAMTS13 Activity
  • Complement, Total (CH50)
  • D-Dimer
  • Factor VIII Activity
  • Lactic Acid Dehydrogenase (LDH)
  • von Willebrand Antigen

Test Number: 164049

Test Name: COVID-19 Severe Disease Progression Risk Profile

Use:
Comprehensive panel for the assessment of patients at risk of severe COVID-19 disease progression. Increased levels of the markers in this profile are associated with a higher risk of progression to severe COVID-19. NLR of less than 3.0 is reported to be associated with clinical improvement in COVID-19 patients5, while CRP below 20 mg/L is associated with non-severe COVID-19 disease.6 Elevated levels of D-Dimer and IL-6 greater than 24 pg/mL is associated with severe disease progression and high sensitivity and specificity for early prediction of severity of COVID-19.7 NLR above 4.9 is reported to be significantly associated with risk of intubation.8,9 Elevated levels of LDH, ferritin, and NT-proBNP are reported to be associated with severe COVID-19.10,11,12 CRP greater than 26 mg/L and PCT greater than 2.0 ng/mL are reported to be associated with risk of severe disease progression.10,11,12

Components

  • C-Reactive Protein (CRP), Quantitative
  • D-Dimer
  • Ferritin, Serum
  • Interleukin-6 (IL-6), Serum
  • Lactic Acid Dehydrogenase (LDH)
  • Neutrophil to Lymphocyte Ratio (NLR)
  • NT-proBNP
  • Procalcitonin (PCT)

Test Number: 164052

Test Name: COVID-19 Triage Profile

Use:
Assessment of patients at risk of progression to severe COVID-19 within 7 days from admission.13  NLR of less than 3.0 is reported to be associated with clinical improvement in COVID-19 patients5 while CRP below 20 mg/L is associated with non-severe COVID-19 disease.6 Elevated levels of D-Dimer, NLR greater than 4.6, and CRP greater than 26 mg/L were reported to be associated with risk of severe disease.9,10,11,12 These markers can assist in triaging patients at the time of admission.13

Components

  • C-Reactive Protein (CRP), Quantitative
  • D-Dimer
  • Neutrophil to Lymphocyte Ratio (NLR)

Test Number: 164081

Test Name: COVID-19 Poor Outcomes Risk Profile

Use:
Assessment of patients at risk of mortality from COVID-19 disease. Increased levels of the markers in this profile are associated with a higher risk of progression to severe COVID-19. Elevated levels of D-Dimer, LDH, ferritin, and NLR above 4.9 are reported to predict risk of poor outcomes of COVID-19.8,9,10,11,12

Components

  • D-Dimer
  • Ferritin, Serum
  • Lactic Acid Dehydrogenase (LDH)
  • Neutrophil to Lymphocyte Ratio (NLR)

Test Number: 165039

Test Name: Post-COVID 19 Fatigue Evaluation

Use:
Subacute fatigue is defined as lasting between one and six months, and chronic fatigue as lasting more than six months. Fatigue that is greater than one- month duration may be due to an underlying chronic medical or psychological condition. Medication toxicity or substance use should also be considered. Common underlying conditions that may present as chronic fatigue include anemia, chronic renal disease, chronic liver disease, hypercalcemia, hyponatremia, hypothyroidism, diabetes, heart disease, depression, and obesity. The tests in the profile were selected to support Limited testing in patients suffering subacute or chronic fatigue to rule out an underlying medical condition.14,15,16

Components

  • CBC (with Differential) 
  • TSH (µIU/mL)
  • AST (IU/L)
  • ALT (IU/L)
  • Albumin (pg/mL)
  • Creatinine (mg/dL)
  • BUN (mg/dL)
  • Sodium (mmol/L)
  • Calcium (mg/dL)
  • HbA1C (%)

References

  1. Goshua G et al. Endoteliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. Lancet Haematol 2020;7:e575-82.
  2. Mancini E et al. The ADAMTS13-von Willebrand factor axis in COVID-19 patients. J Thromb Haemost. 2020;00:1–9 DOI: 10.1111/jth.15191
  3. Doevelaar A et al. COVID-19 is associated with relative ADAMTS13 deficiency and VWF multimer formation resembling TTP. medRxiv preprint doi: https://doi.org/10.1101/2020.08.23.20177824. 
  4. Go RS et al. Thrombotic Microangiopathy Care Pathway: A Consensus Statement for the Mayo Clinic Complement Alternative Pathway-Thrombotic Microangiopathy (CAP-TMA) Disease-Oriented Group. Mayo Clin Proc. 2016;91(9):1189-1211.
  5. Cicculo A et al. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line. Intema1ional Journal of Antimicrobial Agents 2020;18:56. https://doi.org/ 10.1016/j.ijant imicag.2020.106017
  6. Yang A-P et al. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. International Immunopharmacology 2020 (84) https://doi.org/10.1016/j.intimp.2020.106504
  7. Gao Y et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID‐19. J Med Virol. 2020;92:791–796.
  8. Kerboua KE. NLR: A Cost-effective Nomogram to Guide Therapeutic Interventions in COVID-19. Immunological Investigations https://doi.org/10.1080/08820139.2020.1773850 
  9. Tatum D et al. Neutrophil-to-lymphocyte ratio and outcomes in Louisiana COVID-19 patients. Shock. doi: 10.1097/SHK.0000000000001585
  10. Velavan TP, Meyer CG. Miold versus severe COVID-19: Laboratory markers. International Journal of infectious Diseases 2020; 95:304-7.
  11. Aloisio E et al. A Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID-19 Severity. Arch Pathol Lab Med. 2020;144:1457–1464.
  12. Tjendra Y et al. Predicting Disease Severity and Outcome in COVID-19 Patients. Arch Pathol Lab Med. 2020;144:1465–1474.
  13. Liu Y-P et al. Combined use of the neutrophil-to-lymphocyte ratio and CRP to predict 7-day disease severity in 84 hospitalized patients with COVID-19 pneumonia: a retrospective cohort study. Ann Transl Med 2020;8(10):635.
  14. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline. Published: 18 December 2020. www.nice.org.uk/guidance/ng188 
  15. Coronavirus disease 2019 (COVID-19): Evaluation and management of adults following acute viral illness. Up To Date Topic 129312 Version 12.0. Accessed 3/11/2021.
  16. Approach to the adult patient with fatigue. UpToDate Topic 2783 Version 38.0. Accessed 3/11/2021.

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