严重 COVID-19 患者临床实验室数据测定的诊断效用。

Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19.

机构信息

Department of Clinical Laboratory, Fuyang Second People's Hospital, Fuyang, Anhui, China.

Department of Pharmacy, Fuyang People's Hospital, Fuyang, Anhui, China.

出版信息

J Med Virol. 2020 Jul;92(7):791-796. doi: 10.1002/jmv.25770. Epub 2020 Apr 10.

Abstract

The role of clinical laboratory data in the differential diagnosis of the severe forms of COVID-19 has not been definitely established. The aim of this study was to look for the warning index in severe COVID-19 patients. We investigated 43 adult patients with COVID-19. The patients were classified into mild group (28 patients) and severe group (15 patients). A comparison of the hematological parameters between the mild and severe groups showed significant differences in interleukin-6 (IL-6), d-dimer (d-D), glucose, thrombin time, fibrinogen, and C-reactive protein (P < .05). The optimal threshold and area under the receiver operator characteristic curve (ROC) of IL-6 were 24.3 and 0.795 µg/L, respectively, while those of d-D were 0.28 and 0.750 µg/L, respectively. The area under the ROC curve of IL-6 combined with d-D was 0.840. The specificity of predicting the severity of COVID-19 during IL-6 and d-D tandem testing was up to 93.3%, while the sensitivity of IL-6 and d-D by parallel test in the severe COVID-19 was 96.4%. IL-6 and d-D were closely related to the occurrence of severe COVID-19 in the adult patients, and their combined detection had the highest specificity and sensitivity for early prediction of the severity of COVID-19 patients, which has important clinical value.

摘要

临床实验室数据在 COVID-19 严重形式的鉴别诊断中的作用尚未确定。本研究旨在寻找严重 COVID-19 患者的预警指标。我们调查了 43 名成年 COVID-19 患者。将患者分为轻症组(28 例)和重症组(15 例)。对轻症和重症组之间的血液学参数进行比较,发现白细胞介素 6(IL-6)、D-二聚体(d-D)、葡萄糖、凝血酶时间、纤维蛋白原和 C 反应蛋白(P <.05)存在显著差异。IL-6 的最佳阈值和受试者工作特征曲线(ROC)下面积分别为 24.3 和 0.795µg/L,d-D 分别为 0.28 和 0.750µg/L。IL-6 和 d-D 的 ROC 曲线下面积为 0.840。IL-6 和 d-D 串联检测预测 COVID-19 严重程度的特异性高达 93.3%,而 IL-6 和 d-D 在严重 COVID-19 中的并联检测的敏感性为 96.4%。IL-6 和 d-D 与成年患者严重 COVID-19 的发生密切相关,联合检测对预测 COVID-19 患者严重程度具有最高的特异性和敏感性,具有重要的临床价值。

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