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COVID-19 Severe Disease Progression Risk Profile

CPT 82728; 83529; 83615; 83880; 84145; 85025; 85379; 86140

Test Details

Methodology

See individual test components.

Result Turnaround Time

2 - 4 days

Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.

Related Documents

Test Includes

C-Reactive Protein (CRP), Quantitative; D-Dimer; Ferritin, Serum; Interleukin-6, Serum; Lactic Acid Dehydrogenase (LD); Neutrophil to Lymphocyte Ratio (NLR), Complete Blood Count (CBC) With Differential and Platelet; NT-proBNP; Procalcitonin

Use

Comprehensive panel for the assessment of patients at risk of severe COVID-19 disease progression

Special Instructions

This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.

Limitations

For Interleukin-6, Serum [140916]: This test has not been FDA cleared or approved. This test has been authorized by FDA under and EUA for use by authorized laboratories. This test has been authorized only to assist in identifying severe inflammatory response, when used as an aid in determining the risk of intubation with mechanical ventilation in confirmed COVID-19 patients. This test is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of medical devices under Section 564(b)(1) of the Act, 21 U.S.C. & 360bbb-3(b), unless the authorization is terminated or revoked sooner.

Further limitations include:

• For diagnostic purposes, the results should always be assessed in conjunction with the patient's medical history, clinical examination and other findings.

• Individual IL-6 levels need to be considered in combination with other clinical findings to mitigate the possible risks of false positive or false negative IL-6 results.

• In the event of a false positive result, risk to patients could include additional unnecessary intensive care admission, intubation with mechanical ventilation, and other unnecessary supportive therapy.

• Low IL-6 levels indicate that it is less likely that the patient suffers from a cytokine release syndrome and the risk for respiratory support is reduced. However, low levels if IL-6 do not preclude disease progression and future development of severe inflammatory response.

• A false negative result may occur if the test reports lower values than actual levels of IL-6 that are in the sample. When diagnostic testing is negative, the possibility of a false negative result should be considered in the context of a patient's clinical presentation and the presence of clinical signs and symptoms consistent with severe inflammatory response.

• Risk to a patient of a false negative result include: delayed or lack of supportive respiratory treatment, or other unintended adverse events.

• In rare cases, interference due to extremely high titers of antibodies to analyte-specific antibodies, streptavidinor ruthenium can occur. These effects are minimized by suitable test design.

References

Aloisio E, Chibireva M, Serafini L, et al. A Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID-19 Severity. Arch Pathol Lab Med. 2020 Dec 1;144(12):1457-1464.32649222
Cicculo A, Borghetti A, Dal Verme LZ, et al. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line. Int J Antimicrob Agents. 2020 Aug;56(2):106017.32437920
Gao Y, Li T, Han M, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020 Jul;92(7):791-796.32181911
Kerboua KE. NLR: A Cost-effective Nomogram to Guide Therapeutic Interventions in COVID-19. Immunol Invest. 2021 Jan;50(1):92-100.32482134
Tatum D, Taghavi S, Houghton A, Stover J, Toraih E, Duchesne J. Neutrophil-to-lymphocyte ratio and outcomes in Louisiana COVID-19 patients. Shock. 2020 Nov;54(5):652-658.32554992
Tjendra Y, Al Mana AF, Espejo AP, et al. Predicting Disease Severity and Outcome in COVID-19 Patients. Arch Pathol Lab Med. 2020 Dec 1;144(12):1465-1474.32818235
Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis. 2020 Jun;95:304-307.32344011
Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020 Jul;84:106504.32304994

Specimen Requirements

Specimen

Serum, plasma, and whole blood

Volume

5 mL serum, 2 mL plasma (sodium citrate), and 4 mL whole blood (EDTA)

Minimum Volume

3.5 mL serum, 1 mL plasma (sodium citrate), and 4 mL whole blood (Note: This volume does not allow for repeat testing.)

Container

Gel-barrier tube, blue-top (sodium citrate) tube, and lavender-top (EDTA) tube

Collection Instructions

Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells.Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No 49482). Freeze plasma within four hours of blood collection and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit seperate frozen specimens for each test requested.

Storage Instructions

Frozen: Serum and plasma

Room temperature: Serum and whole blood (EDTA)

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
164049 COVID-19 Severe Disease Risk 001115 LDH IU/L 14804-9
164049 COVID-19 Severe Disease Risk 004598 Ferritin ng/mL 2276-4
164049 COVID-19 Severe Disease Risk 140922 Interleukin-6, Serum pg/mL 26881-3
164049 COVID-19 Severe Disease Risk 143001 NT-proBNP pg/mL 33762-6
164049 COVID-19 Severe Disease Risk 164752 Procalcitonin ng/mL 33959-8
164049 COVID-19 Severe Disease Risk 006627 C-Reactive Protein, Quant mg/L 1988-5
164049 COVID-19 Severe Disease Risk 115206 D-Dimer mg/L FEU 48065-7
164049 COVID-19 Severe Disease Risk 005025 WBC x10E3/uL 6690-2
164049 COVID-19 Severe Disease Risk 005033 RBC x10E6/uL 789-8
164049 COVID-19 Severe Disease Risk 005041 Hemoglobin g/dL 718-7
164049 COVID-19 Severe Disease Risk 005058 Hematocrit % 4544-3
164049 COVID-19 Severe Disease Risk 015065 MCV fL 787-2
164049 COVID-19 Severe Disease Risk 015073 MCH pg 785-6
164049 COVID-19 Severe Disease Risk 015081 MCHC g/dL 786-4
164049 COVID-19 Severe Disease Risk 105007 RDW % 788-0
164049 COVID-19 Severe Disease Risk 015172 Platelets x10E3/uL 777-3
164049 COVID-19 Severe Disease Risk 015107 Neutrophils % 770-8
164049 COVID-19 Severe Disease Risk 015123 Lymphs % 736-9
164049 COVID-19 Severe Disease Risk 015131 Monocytes % 5905-5
164049 COVID-19 Severe Disease Risk 015149 Eos % 713-8
164049 COVID-19 Severe Disease Risk 015156 Basos % 706-2
164049 COVID-19 Severe Disease Risk 115398 Immature Cells N/A
164049 COVID-19 Severe Disease Risk 015909 Neutrophils (Absolute) x10E3/uL 751-8
164049 COVID-19 Severe Disease Risk 015917 Lymphs (Absolute) x10E3/uL 731-0
164049 COVID-19 Severe Disease Risk 015912 Neut/Lymph Ratio ratio N/A
164049 COVID-19 Severe Disease Risk 015925 Monocytes(Absolute) x10E3/uL 742-7
164049 COVID-19 Severe Disease Risk 015933 Eos (Absolute) x10E3/uL 711-2
164049 COVID-19 Severe Disease Risk 015941 Baso (Absolute) x10E3/uL 704-7
164049 COVID-19 Severe Disease Risk 015108 Immature Granulocytes % 71695-1
164049 COVID-19 Severe Disease Risk 015911 Immature Grans (Abs) x10E3/uL 53115-2
164049 COVID-19 Severe Disease Risk 015945 NRBC % 58413-6
164049 COVID-19 Severe Disease Risk 015180 Hematology Comments: 18314-5
164049 COVID-19 Severe Disease Risk 164046 Severe Disease Progression N/A
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code001115
Result Code NameLDH
UofMIU/L
Result LOINC14804-9
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code004598
Result Code NameFerritin
UofMng/mL
Result LOINC2276-4
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code140922
Result Code NameInterleukin-6, Serum
UofMpg/mL
Result LOINC26881-3
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code143001
Result Code NameNT-proBNP
UofMpg/mL
Result LOINC33762-6
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code164752
Result Code NameProcalcitonin
UofMng/mL
Result LOINC33959-8
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code006627
Result Code NameC-Reactive Protein, Quant
UofMmg/L
Result LOINC1988-5
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code115206
Result Code NameD-Dimer
UofMmg/L FEU
Result LOINC48065-7
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code005025
Result Code NameWBC
UofMx10E3/uL
Result LOINC6690-2
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code005033
Result Code NameRBC
UofMx10E6/uL
Result LOINC789-8
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code005041
Result Code NameHemoglobin
UofMg/dL
Result LOINC718-7
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code005058
Result Code NameHematocrit
UofM%
Result LOINC4544-3
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015065
Result Code NameMCV
UofMfL
Result LOINC787-2
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015073
Result Code NameMCH
UofMpg
Result LOINC785-6
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015081
Result Code NameMCHC
UofMg/dL
Result LOINC786-4
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code105007
Result Code NameRDW
UofM%
Result LOINC788-0
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015172
Result Code NamePlatelets
UofMx10E3/uL
Result LOINC777-3
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015107
Result Code NameNeutrophils
UofM%
Result LOINC770-8
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015123
Result Code NameLymphs
UofM%
Result LOINC736-9
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015131
Result Code NameMonocytes
UofM%
Result LOINC5905-5
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015149
Result Code NameEos
UofM%
Result LOINC713-8
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015156
Result Code NameBasos
UofM%
Result LOINC706-2
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code115398
Result Code NameImmature Cells
UofM
Result LOINCN/A
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015909
Result Code NameNeutrophils (Absolute)
UofMx10E3/uL
Result LOINC751-8
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015917
Result Code NameLymphs (Absolute)
UofMx10E3/uL
Result LOINC731-0
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015912
Result Code NameNeut/Lymph Ratio
UofMratio
Result LOINCN/A
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015925
Result Code NameMonocytes(Absolute)
UofMx10E3/uL
Result LOINC742-7
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015933
Result Code NameEos (Absolute)
UofMx10E3/uL
Result LOINC711-2
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015941
Result Code NameBaso (Absolute)
UofMx10E3/uL
Result LOINC704-7
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015108
Result Code NameImmature Granulocytes
UofM%
Result LOINC71695-1
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015911
Result Code NameImmature Grans (Abs)
UofMx10E3/uL
Result LOINC53115-2
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015945
Result Code NameNRBC
UofM%
Result LOINC58413-6
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code015180
Result Code NameHematology Comments:
UofM
Result LOINC18314-5
Order Code164049
Order Code NameCOVID-19 Severe Disease Risk
Order Loinc
Result Code164046
Result Code NameSevere Disease Progression
UofM
Result LOINCN/A
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115400 Bands % 35332-6
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115400
Result NameBands
UofM%
Result LOINC35332-6
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115401 Metamyelocytes % 28541-1
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115401
Result NameMetamyelocytes
UofM%
Result LOINC28541-1
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115403 Myelocytes % 26498-6
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115403
Result NameMyelocytes
UofM%
Result LOINC26498-6
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115404 Promyelocytes % 26498-6
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115404
Result NamePromyelocytes
UofM%
Result LOINC26498-6
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115405 Blasts/blast like cells % 26498-6
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115405
Result NameBlasts/blast like cells
UofM%
Result LOINC26498-6
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115406 Megakaryocytes % 19252-6
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115406
Result NameMegakaryocytes
UofM%
Result LOINC19252-6
Reflex Table for Immature Cells
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 115399 Immature Cells 115265 Other, Lineage Uncertain % 55433-7
Reflex 1
Order Code115399
Order NameImmature Cells
Result Code115265
Result NameOther, Lineage Uncertain
UofM%
Result LOINC55433-7