Han Yi, Zhang Haidong, Mu Sucheng, Wei Wei, Jin Chaoyuan, Tong Chaoyang, Song Zhenju, Zha Yunfei, Xue Yuan, Gu Guorong
Emergency Department, Zhongshan Hospital, Fudan University, Shanghai 20032, China.
Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
Aging (Albany NY). 2020 Jun 24;12(12):11245-11258. doi: 10.18632/aging.103372.
The World Health Organization has declared coronavirus disease 2019 (COVID-19) a public health emergency of global concern. Updated analysis of cases might help identify the risk factors of illness severity.
The median age was 63 years, and 44.9% were severe cases. Severe patients had higher APACHE II (8.5 vs. 4.0) and SOFA (2 vs. 1) scores on admission. Among all univariable parameters, lymphocytes, CRP, and LDH were significantly independent risk factors of COVID-19 severity. LDH was positively related both with APACHE II and SOFA scores, as well as P/F ratio and CT scores. LDH (AUC = 0.878) also had a maximum specificity (96.9%), with the cutoff value of 344.5. In addition, LDH was positively correlated with CRP, AST, BNP and cTnI, while negatively correlated with lymphocytes and its subsets.
This study showed that LDH could be identified as a powerful predictive factor for early recognition of lung injury and severe COVID-19 cases.
We extracted data regarding 107 patients with confirmed COVID-19 from Renmin Hospital of Wuhan University. The degree of severity of COVID-19 patients (severe vs. non-severe) was defined at the time of admission according to American Thoracic Society guidelines for community acquired pneumonia.
世界卫生组织已宣布2019冠状病毒病（COVID-19）为全球关注的突发公共卫生事件。对病例的最新分析可能有助于确定疾病严重程度的危险因素。
中位年龄为63岁，44.9%为重症病例。重症患者入院时的急性生理与慢性健康状况评分系统II（APACHE II）（8.5对4.0）和序贯器官衰竭评估（SOFA）（2对1）评分更高。在所有单变量参数中，淋巴细胞、C反应蛋白（CRP）和乳酸脱氢酶（LDH）是COVID-19严重程度的显著独立危险因素。LDH与APACHE II和SOFA评分、以及氧合指数（P/F）和胸部CT评分均呈正相关。LDH（曲线下面积[AUC]=0.878）也具有最高的特异性（96.9%），临界值为344.5。此外，LDH与CRP、天门冬氨酸氨基转移酶（AST）、脑钠肽（BNP）和心肌肌钙蛋白I（cTnI）呈正相关，而与淋巴细胞及其亚群呈负相关。
本研究表明，LDH可被确定为早期识别肺损伤和重症COVID-19病例的有力预测因素。
我们从武汉大学人民医院提取了107例确诊COVID-19患者的数据。根据美国胸科学会社区获得性肺炎指南，在入院时定义COVID-19患者的严重程度（重症与非重症）。
