Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China (mainland).
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2020 Sep 11;26:e926393. doi: 10.12659/MSM.926393.
BACKGROUND The aim of this study was to determine the effect of C-reactive protein (CRP), lymphocytes (LYM), and the ratio of CRP to LYM (CRP/LYM) on assessing the prognosis of COVID-19 severity at early stages of disease. MATERIAL AND METHODS A total of 108 hospitalized patients diagnosed with COVID-19 in Zhongnan Hospital of Wuhan University from January 17, 2020 to March 12, 2020 were enrolled. Data of demographic parameters, clinical characteristics, laboratory indicators, clinical manifestation, and outcome of disease were collected. The patients were divided into a severe group and a non-severe group according to diagnosis and classification, which followed the guidelines and management of the Chinese National Health Council COVID-19. The receiver-operating characteristic (ROC) analysis and comparison of ROC curves were used for the laboratory findings for assessment of COVID-19 severity. RESULTS Of the 108 patients, 42 patients (38.9%) were male and 24 patients (22.2%) were considered severe cases, with the mean age of 51.0 years old. Males and patients with comorbidities were more likely to become severe cases. CRP increased and LYM decreased in the severe group.The results for the areas under the curve (AUC) of CRP/LYM and CRP used to assess severe COVID-19 were 0.787 (95% CI 0.698-0.860, P<0.0001) and 0.781 (95% CI 0.693-0.856, P<0.0001), respectively; both results were better than that of LYM. The associated criterion value of CRP/LYM was calculated, with an excellent sensitivity of 95.83%. CONCLUSIONS The effect of CRP/LYM and CRP on the assessment for severe COVID-19 may be superior to LYM alone. CRP/LYM is a highly sensitive indicator to assess the severity of COVID-19 in the early stage of disease.
本研究旨在探讨 C 反应蛋白（CRP）、淋巴细胞（LYM）和 CRP 与 LYM 的比值（CRP/LYM）在评估疾病早期 COVID-19 严重程度预后中的作用。
选取 2020 年 1 月 17 日至 3 月 12 日期间在武汉大学中南医院住院的 108 例 COVID-19 患者。收集患者的人口统计学参数、临床特征、实验室指标、临床表现和疾病转归等数据。根据中国国家卫生健康委员会 COVID-19 的诊断和分类标准，将患者分为重症组和非重症组。采用受试者工作特征（ROC）分析和 ROC 曲线比较，评估实验室检查对 COVID-19 严重程度的评估价值。
108 例患者中，男性 42 例（38.9%），重症 24 例（22.2%），平均年龄 51.0 岁。男性和合并基础疾病的患者更容易发展为重症。重症组 CRP 升高，LYM 降低。CRP/LYM 和 CRP 评估重症 COVID-19 的曲线下面积（AUC）分别为 0.787（95%CI 0.698-0.860，P<0.0001）和 0.781（95%CI 0.693-0.856，P<0.0001），均优于 LYM。计算 CRP/LYM 的截断值，其灵敏度高达 95.83%。
CRP/LYM 和 CRP 对评估重症 COVID-19 的作用可能优于单独使用 LYM。CRP/LYM 是一种早期评估 COVID-19 严重程度的高度敏感指标。
