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血液生化指标对新型冠状病毒肺炎严重程度的预测效能

The Predictive Effectiveness of Blood Biochemical Indexes for the Severity of COVID-19.

作者信息

Zhou Yingchu, Li Bo, Liu Jiyang, Chen Dong

机构信息

The First Hospital of Changsha, The Hospital of Infectious Diseases of Changsha, The Public Health Treatment Center of Changsha, Changsha 410005, China.

出版信息

Can J Infect Dis Med Microbiol. 2020 Aug 7;2020:7320813. doi: 10.1155/2020/7320813. eCollection 2020.

Abstract

OBJECTIVE

We aimed to explore the predictive effectiveness of blood biochemical indexes for COVID-19 severity.

METHOD

We retrospectively analyzed the clinical data of COVID-19 patients who were cured and discharged from the Public Health Treatment Center of Changsha from January 30, 2020, to February 19, 2020. According to the clinical classification of the disease, the patients were divided into severe and nonsevere groups. General clinical data and underlying medical conditions were recorded through the electronic medical record (EMR) system. Laboratory examination results of the patients during their hospitalization were collected, including the first results for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), peripheral blood lymphocyte ratio and count, and peripheral blood white blood cell (WBC) count. Univariate and multivariate logistic regression models were used to analyze the predictive effectiveness of blood biochemical indexes and other related factors for COVID-19 severity.

RESULT

In all, 108 COVID-19 patients (median age: 43.9 years (range: 1-75); male patients: 56 (51.85%)) were enrolled, of whom 24 (22.22%) showed severe disease and 84 (77.78%) showed nonsevere disease, and two in 24 patients with severe disease developed into a critically severe type and died. Fever was the most common onset symptom (67.59%), followed by cough (48.15%) and fatigue (37.04%). Comorbidities were important factors affecting the severity of COVID-19, and among the patients with severe disease, the proportion with comorbidities was 70.83%, and the proportion without comorbidities was 29.17%. The intergroup difference was significant ( < 0.05). In patients with CRP levels (mg/L) of ≤8, >8-≤20, >20-≤40, and >40, the proportions of those with severe and nonsevere disease were 0 to 32, 7 to 19, 6 to 23, and 11 to 10, respectively; the intergroup difference was significant ( < 0.05).

CONCLUSION

The presence or absence of comorbidities and CRP elevation were independent significant predictors of COVID-19 severity, and hypertension was found as the most common comorbidity in patients with severe disease.

摘要

目的

我们旨在探讨血液生化指标对新型冠状病毒肺炎(COVID-19)严重程度的预测效能。

方法

我们回顾性分析了2020年1月30日至2020年2月19日从长沙市公共卫生治疗中心治愈出院的COVID-19患者的临床资料。根据疾病的临床分类,将患者分为重症组和非重症组。通过电子病历(EMR)系统记录一般临床资料和基础疾病情况。收集患者住院期间的实验室检查结果,包括红细胞沉降率(ESR)、C反应蛋白(CRP)、外周血淋巴细胞比例和计数以及外周血白细胞(WBC)计数的首次结果。采用单因素和多因素logistic回归模型分析血液生化指标及其他相关因素对COVID-19严重程度的预测效能。

结果

共纳入108例COVID-19患者(中位年龄:43.9岁(范围:1 - 75岁);男性患者:56例(51.85%)),其中24例(22.22%)为重症,84例(77.78%)为非重症,24例重症患者中有2例进展为危重症并死亡。发热是最常见的起病症状(67.59%),其次是咳嗽(48.15%)和乏力(37.04%)。合并症是影响COVID-19严重程度的重要因素,重症患者中合并症患者的比例为70.83%,无合并症患者的比例为29.17%。组间差异有统计学意义(<0.05)。CRP水平(mg/L)≤8、>8至≤20、>20至≤40和>40的患者中,重症和非重症患者的比例分别为0至32、7至19、6至23和11至10;组间差异有统计学意义(<0.05)。

结论

合并症的有无及CRP升高是COVID-19严重程度的独立显著预测因素,且发现高血压是重症患者中最常见的合并症。

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