Department of Hematology, The First Affiliated Hospital of Soochow University, National Clinical Research Center for Hematologic Diseases, Soochow University, Suzhou 215006, China; Department of Pulmonary, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou 215007, China; Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Thromb Res. 2020 Aug;192:3-8. doi: 10.1016/j.thromres.2020.05.006. Epub 2020 May 6.
To investigate the clinical features of COVID-19 cases in Suzhou China. Biomarkers were screened out of hematological parameters for risk stratification.
Confirmed COVID-19 adult patients in Suzhou were included. The patient data was collected, and the results of laboratory examinations were compared between the mild/moderate and severe COVID-19 groups. A ROC was calculated to compare the diagnostic performance of candidate indexes, and dynamic levels of hematological indexes were compared between the two groups.
75 patients were enrolled, with a mean age of 46.6 ± 14 years, and 45 patients were male. All patients were classified into two groups: the mild/moderate group and the severe group. WBC, neutrophil to lymphocyte ratio (NLR), D-dimer, and fibrinogen levels of the severe group were significantly higher (P < 0.05) than the mild/moderate, and the lymphocyte was lower. The ROC test showed that the hematological parameters had a larger AUC than that of inflammatory factors. There was a significant difference in lymphocyte and fibrinogen levels between the two groups on day 1 (P < 0.05). However, NLR of the severe group was higher than the mild/moderate on days 1, 4 and 14 (P < 0.01), and so was D-dimer on days 1, 7 and 14 (P < 0.05).
The common COVID-19 abnormal hematological indexes on admission included hyperfibrinogenemia, lymphopenia, the elevation of D-dimer, and leukopenia, which were significantly different between the mild/moderate and severe COVID-19 groups. Furthermore, the dynamic change of NLR and D-dimer level can distinguish severe COVID-19 cases from the mild/moderate.
研究中国苏州 COVID-19 病例的临床特征。筛选出血象参数中的生物标志物进行风险分层。
纳入苏州确诊的成年 COVID-19 患者。收集患者数据，比较轻症/普通组和重症组实验室检查结果。计算 ROC 以比较候选指标的诊断性能，并比较两组之间的血液学指标动态水平。
共纳入 75 例患者，平均年龄为 46.6±14 岁，其中男性 45 例。所有患者均分为轻症/普通组和重症组。重症组的白细胞计数（WBC）、中性粒细胞与淋巴细胞比值（NLR）、D-二聚体和纤维蛋白原水平显著高于轻症/普通组（P<0.05），而淋巴细胞则较低。ROC 测试表明，血液学参数的 AUC 大于炎症因子。两组患者在第 1 天的淋巴细胞和纤维蛋白原水平存在显著差异（P<0.05）。然而，重症组的 NLR 在第 1、4 和 14 天均高于轻症/普通组（P<0.01），D-二聚体在第 1、7 和 14 天也高于轻症/普通组（P<0.05）。
入院时常见的 COVID-19 异常血液学指标包括高纤维蛋白原血症、淋巴细胞减少、D-二聚体升高和白细胞减少，轻症/普通组和重症 COVID-19 组之间存在显著差异。此外，NLR 和 D-二聚体水平的动态变化可区分重症 COVID-19 病例和轻症/普通病例。
