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Volume:
Biochimica Clinica 2020; 44(4) 023-024
Pubblicato on-line:
October 16, 2020
DOI:
10.19186/BC_2020.082
SARS-CoV-2: nuove prospettive della diagnostica di laboratorio
SARS-CoV-2: new perspectives for the clinical laboratory diagnostics
AUTORI
1Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata, Sezione di Biochimica Clinica, Medicina Molecolare Clinica e Medicina di Laboratorio, Università degli Studi di Palemro, Italia
2Dipartimento di Medicina di Laboratorio, AOUP "Paolo Giaccone" di Palermo, Palermo, Italia
ABSTRACT
SARS-CoV-2: new perspectives for the clinical laboratory diagnostics
The new Coronavirus Disease 2019 (COVID-19), caused by the virus SARS-CoV-2, is characterized by a broad spectrum of clinical manifestations and different degrees of severity, ranging from asymptomatic/mild symptoms to Acute Respiratory Distress Syndrome (ARDS) and Multiple Organ Failure (MOF), potentially life-threatening. The clinical course of COVID-19 includes usually three stages. The first stage, defined as “early infection”, occurs at the time of virus infiltration in the lung parenchyma, via the interaction of SARS-CoV-2 with the angiotensin-converting enzyme 2 (ACE2) in ciliated bronchial epithelial cells. The second step, the “pulmonary phase”, is characterized by viral pneumonia with localized inflammation within the lung. The third stage, the “hyperinflammation phase”, is the most severe because of the development of a systemic inflammation and cytokine overproduction leading to ARDS and MOF.
In this complex contest, the laboratory can provide a strong support for the appropriate clinical management of COVID-19 for diagnosis, prognosis, and monitoring of the disease. Current research focuses on the potential role of immune and/or inflammatory biomarkers as useful tools in COVID-19 patients. In this narrative review, we will provide an overview about some of these biomarkers: procalcitonin, mid regional-pro adrenomedullin, presepsin, soluble fms-like tyrosine kinase 1/placental growth factor, ACE2, interleukin-6 and vitamin D.