Which lab findings are commonly found in pediatric coronavirus disease 2019 (COVID-19)?

Updated: Oct 10, 2021
  • Author: Ayesha Mirza, MD; Chief Editor: David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS  more...
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Answer

Answer

A consistent pattern of laboratory abnormalities has not yet been identified in children with confirmed coronavirus disease 2019 (COVID-19). Early in the course of the disease, the white blood cell count is normal or decreased, and the lymphocyte count is decreased. The majority of patients have normal neutrophil counts.

Levels of liver and muscle enzymes and myoglobin are increased in some children. Many patients have elevated C-reactive protein (CRP) levels and erythrocyte sedimentation rates. In severe cases, patients have high D-dimer levels and progressively decreasing lymphocyte counts. [51]

In a literature review of case reports involving 66 children and adolescents with confirmed COVID-19, Henry et al found that CRP and procalcitonin (PCT) levels were elevated in 13.6% and 10.6% of cases, respectively. [64]  In a study that included 20 pediatric inpatients in Wuhan, China, 80% of the children had elevated PCT levels. [4]  Because PCT values can increase significantly in systemic bacterial infections and sepsis, higher levels are strongly suggestive of bacterial co-infection in patients with COVID-19. [65]


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