PNEUMONIA: Natural history laboratory abnormality in COVID-19

Introduction: COVID19 is a new disease caused by the SARS CoV-2 virus which became pandemic in 2019. In October 2020, COVID 19 cases in Indonesia continued to increase, reaching 304,007 cases. The mortality rate of this disease is 3.6%. This disease shows many symptoms such as asymptomatic, fever, cough, diarrhoea, severe shortness of breath. Case: 53 years-old man with fever for five days with cough, sore throat, and tightness. Physical examination revealed a temperature of 38 °C and bilateral lung crackles with ground-glass opacity of the right lung in pulmonary CT scan. PCR results obtained positive SARS-CoV 2. Discussion: In the early phase of COVID19 infection, complete peripheral blood tests tended to be normal with a mild increase in CRP. When ARDS occurs, there is a significant decrease in absolute lymphocyte, and increased CRP levels. The decreased Hb levels accompanied by increased LDH is suspected hemolysis of erythrocyte. Other laboratory examination shows an increase of acute phase reactants such as D-dimers, fibrinogen, and ferritin that indicate a severe inflammatory state. By the progression of the disease, laboratory abnormality such as decreased absolute lymphocytes and increased inflammatory markers happened on the 12^th day after symptoms.