Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Epidemiol Infect. 2020 Jun 30;148:e129. doi: 10.1017/S0950268820001442.
To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.
为了描述 2019 年冠状病毒病（COVID-19）死亡病例的实验室检查结果，并建立预测死亡的评分系统，我们进行了这项单中心、回顾性、观察性研究，纳入了华中科技大学同济医学院附属协和医院两个病房的 336 例成人重症或危重症 COVID-19 患者（年龄≥18 岁），这些患者在 2020 年 2 月 1 日至 2020 年 3 月 13 日之间有明确的结局（死亡或出院）。我们采用单变量和多变量逻辑回归分析来确定与死亡率相关的因素。我们将多个因素结合起来预测死亡率，并通过接受者操作特征曲线进行验证。结果，在总共 336 例患者中，有 34 例（10.1%）患者在住院期间死亡。通过多变量逻辑回归，我们发现入院时淋巴细胞比值（Lymr，%）降低（优势比，OR 0.574，P<0.001）、血尿素氮（BUN）升高（OR 1.513，P=0.009）和 D-二聚体（DD）升高（OR 1.334，P=0.002）与死亡密切相关。该联合预测模型由这些因素构建，具有 100.0%的敏感性和 97.2%的特异性。总之，在 COVID-19 重症患者中，Lymr 降低、BUN 升高和 DD 升高与死亡结局相关。我们建立了一个评分系统来预测这些患者的临床结局。
