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中国温州地区 COVID-19 患者外周血象系统的异常。

Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China.

机构信息

Gynaecology and Obstetrics, Wenzhou Central Hospital, Dingli Clinical School of Wenzhou Medical University, Wenzhou 325000, China.

Department of Blood Transfusion, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.

出版信息

Clin Chim Acta. 2020 Aug;507:174-180. doi: 10.1016/j.cca.2020.04.024. Epub 2020 Apr 24.

Abstract

BACKGROUND

In December 2019, coronavirus disease 2019 (COVID-19) was first found in Wuhan, China and soon was reported all around the world.

METHODS

All confirmed cases with COVID-19 in Wenzhou from January 19 to February 20, 2020, were collected and analyzed. Of the 116 patients with COVID-19, 27 were diagnosed as severe cases. Among severe cases, 9 were treated in ICU. The data of blood routine examination were analyzed and compared among common patients (as common group), severe patients admitted to intensive care unit (as severe ICU group) and severe patients not admitted to ICU (as severe non-ICU group). The blood routine examination results were dynamically observed in the above groups after admission.

RESULTS

Patients with COVID-19 have lower counts of leucocytes, lymphocytes, eosinophils, platelets, and hemoglobin, but have higher neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), which were compared with controls (P < 0.001). In severe ICU group, patients have the lowest count of lymphocytes, but the highest neutrophil count and NLR among the above three groups (all P values < 0.05); NLR and MLR indicators were combined for diagnostic efficacy analysis of severe COVID-19, and its area under the curve reached 0.925. The odds ratio of the delay in days to the start of the increase of eosinophil count for predicting the outcome of patients with severe COVID-19 was 2.291 after age adjusted.

CONCLUSIONS

Patients with COVID-19 have abnormal peripheral blood routine examination results. Dynamic surveillance of peripheral blood system especially eosinophils is helpful in the prediction of severe COVID-19 cases.

摘要

背景

2019 年 12 月,新型冠状病毒疾病 2019(COVID-19)首先在中国武汉发现,很快就在全世界范围内报道。

方法

收集并分析了 2020 年 1 月 19 日至 2 月 20 日温州所有确诊的 COVID-19 病例。116 例 COVID-19 患者中,27 例诊断为重症病例。在重症病例中,9 例在 ICU 治疗。分析并比较了普通患者(普通组)、重症患者入住 ICU(重症 ICU 组)和重症患者未入住 ICU(重症非 ICU 组)的血常规检查数据。动态观察上述各组入院后血常规检查结果。

结果

与对照组相比(P<0.001),COVID-19 患者的白细胞、淋巴细胞、嗜酸性粒细胞、血小板和血红蛋白计数较低,但中性粒细胞与淋巴细胞比值(NLR)和单核细胞与淋巴细胞比值(MLR)较高。在重症 ICU 组中,患者的淋巴细胞计数最低,但与上述三组相比,中性粒细胞计数和 NLR 最高(均 P 值<0.05);NLR 和 MLR 指标联合用于诊断重症 COVID-19 的效能分析,其曲线下面积达到 0.925。经年龄校正后,预测重症 COVID-19 患者结局的嗜酸粒细胞计数开始增加的延迟天数的比值比为 2.291。

结论

COVID-19 患者外周血常规检查结果异常。动态监测外周血系统,特别是嗜酸性粒细胞,有助于预测重症 COVID-19 病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ab6/7194694/019d3a9f9a53/gr1_lrg.jpg

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