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[中性粒细胞与淋巴细胞比值作为新型冠状病毒肺炎的预后标志物]

[Neutrophil to lymphocyte ratio as a prognostic marker in COVID-19].

作者信息

Basbus Luis, Lapidus Martín I, Martingano Ignacio, Puga María Celeste, Pollán Javier

机构信息

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina. E-mail:

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2020;80 Suppl 3:31-36.

Abstract

In December 2019, a new coronavirus was identified as the cause of an outbreak of pneumonia and respiratory distress in Wuhan, China. It was declared pandemic in March 2020. It is important to know predictors of poor outcomes in order to optimize the strategies of care in newly diagnosed patients. The neutrophil to lymphocyte ratio (NLR) constitutes a novel prognostic marker for oncologic, cardiovascular and infectious diseases. We aimed to assess its prognostic value in COVID-19. We evaluated a retrospective cohort of 131 patients with COVID-19 from March to May 2020. We analyzed the association of an NLR = 3 with severe COVID-19, baseline characteristics of the population and the mortality rate. The median age was 52 years, and 54% were men. 21 patients presented criteria of severe disease, 9 of them required mechanical ventilation. NLR = 3 was found in 81% (18/21) of severe patients and in 33% (36/110) of mild patients (OR = 8.74. 95% CI 2.74-27.86; p < 0.001). Age and hypertension were associated with severe disease. A mortality rate of 7% (9) was obtained. Seven of the 9 patients who died presented NLR = 3, with a significant association between mortality and NLR = 3 (p = 0.03). NLR could be used in conjunction with other predictors, as an early prognostic marker in COVID-19 given its accessibility and low cost.

摘要

2019年12月,一种新型冠状病毒被确定为中国武汉肺炎和呼吸窘迫疫情的病因。2020年3月,该病毒被宣布为大流行病。了解不良预后的预测因素对于优化新诊断患者的治疗策略至关重要。中性粒细胞与淋巴细胞比值(NLR)是肿瘤、心血管和传染病的一种新型预后标志物。我们旨在评估其在新型冠状病毒肺炎(COVID-19)中的预后价值。我们评估了2020年3月至5月的131例COVID-19患者的回顾性队列。我们分析了NLR = 3与重症COVID-19、人群基线特征和死亡率之间的关联。中位年龄为52岁,54%为男性。21例患者出现重症标准,其中9例需要机械通气。81%(18/21)的重症患者和33%(36/110)的轻症患者NLR = 3(比值比 = 8.74,95%置信区间2.74 - 27.86;p < 0.001)。年龄和高血压与重症疾病相关。死亡率为7%(9例)。死亡的9例患者中有7例NLR = 3,死亡率与NLR = 3之间存在显著关联(p = 0.03)。鉴于NLR易于获取且成本低廉,它可与其他预测因素结合使用,作为COVID-19的早期预后标志物。

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