Ghweil Ali A, Hassan Mohammed H, Khodeary Ashraf, Mohamed Ahmed Okasha, Mohammed Haggagy Mansour, Abdelazez Ahmed Alyan, Osman Heba Ahmed, Bazeed Shamardan Ezzeldin S
Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, South Valley University, Qena 83523, Egypt.
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena 83523, Egypt.
Infect Drug Resist. 2020 Jul 17;13:2375-2383. doi: 10.2147/IDR.S263489. eCollection 2020.
The risk factors, disease characteristics, severity, and mortality of COVID-19 are unclear, particularly in Egypt.
The objective was to analyze the patients' characteristics, hematological, biochemical, and chest imaging findings among the cohort of patients with COVID-19 in Egypt and also to shed light on the predictors of COVID-19 severity.
A retrospective study was conducted on 66 patients with COVID-19 in Egypt. Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests . Results of real-time reverse transcription-polymerase chain reaction (rRT-PCR) for detection of SARS-CoV-2 RNA at diagnosis and during follow up of these patients were also recorded.
The study included 36 patients with mild to moderate COVID-19 and 30 patients with severe/critical infection. There was a significant older age among severe (62.6 years old ±10.1SD) than mild to moderate infection (55.5 ± 10.1) (˂0.05). Fever, dry cough, dyspnea, and sore throat malaise were highly frequent among COVID-19 patients, while headache and diarrhea were the least frequently occurring manifestations. All included cases (30 patients, 100%) with severe COVID-19 showed crazy-paving appearance (in the form of reticular and/or interlobular septal thickening) with or without GGO. There were significantly lower mean values of WBCs, lymphocytic count, total protein, and albumin among the severely infected than those who had mild to moderate COVID-19 infection, ˂0.05 for all. Additionally, there were significantly higher mean values of CRP, ESR, ferritin, ALT, and AST among patients with severe/critical COVID-19 when compared with those having mild to moderate COVID-19, ˂0.05 for all.
Among the studied demographic, clinical, hematological, biochemical, and imaging data, dyspnea, diabetes mellitus, lymphopenia, raised CRP, ESR, ferritin, ALT, AST, low albumin, and presence of CT chest findings could be considered as predictors for COVID-19 severity using binary logistic regression analysis.
新型冠状病毒肺炎（COVID-19）的危险因素、疾病特征、严重程度和死亡率尚不清楚，尤其是在埃及。
分析埃及COVID-19患者队列的患者特征、血液学、生化和胸部影像学表现，并阐明COVID-19严重程度的预测因素。
对埃及66例COVID-19患者进行回顾性研究。以全血细胞计数和分类计数、CRP、ESR、血清铁蛋白、肌酐和肝功能检查的形式记录病史、影像学数据（胸部CT表现）以及诊断时测得的血液学和生化参数。还记录了这些患者诊断时和随访期间检测SARS-CoV-2 RNA的实时逆转录-聚合酶链反应（rRT-PCR）结果。
该研究包括36例轻度至中度COVID-19患者和30例重度/危重症感染患者。重度患者（62.6岁±10.1标准差）的年龄显著高于轻度至中度感染患者（55.5±10.1）（P<0.05）。发热、干咳、呼吸困难和咽痛不适在COVID-19患者中非常常见，而头痛和腹泻是最不常见的表现。所有纳入的重度COVID-19病例（30例患者，100%）均表现为铺路石征（呈网状和/或小叶间隔增厚形式），伴或不伴磨玻璃影（GGO）。重度感染患者的白细胞、淋巴细胞计数、总蛋白和白蛋白的平均值显著低于轻度至中度COVID-19感染患者，所有指标P均<0.05。此外，与轻度至中度COVID-19患者相比，重度/危重症COVID-19患者的CRP、ESR、铁蛋白、ALT和AST的平均值显著更高，所有指标P均<0.05。
在研究的人口统计学、临床、血液学、生化和影像学数据中，使用二元逻辑回归分析，呼吸困难、糖尿病、淋巴细胞减少、CRP升高、ESR升高、铁蛋白升高、ALT升高、AST升高、低白蛋白以及胸部CT表现可被视为COVID-19严重程度的预测因素。
