Wang Junhong, Zhang Hua, Qiao Rui, Ge Qinggang, Zhang Shuisheng, Zhao Zongxuan, Tian Ci, Ma Qingbian, Shen Ning
Emergency Department, Peking University Third Hospital, Beijing, China.
Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China.
J Int Med Res. 2020 Sep;48(9):300060520955037. doi: 10.1177/0300060520955037.
The roles of inflammation and hypercoagulation in predicting outcomes of coronavirus disease 2019 (COVID-19) are unclear.
Adult patients diagnosed with COVID-19 from 28 January 2020 to 4 March 2020 in Tongji Hospital, Wuhan were recruited. Data on related parameters were collected. Univariate analysis and multivariable binary logistic regression were used to explore predictors of critical illness and mortality.
In total, 199 and 44 patients were enrolled in the training and testing sets, respectively. Elevated ferritin, tumor necrosis factor-α and D-dimer and decreased albumin concentration were associated with disease severity. Older age, elevated ferritin and elevated interleukin-6 were associated with 28-day mortality. The FAD-85 score, defined as age + 0.01 * ferritin +D-dimer, was used to predict risk of mortality. The sensitivity, specificity and accuracy of FAD-85 were 86.4%, 81.8% and 86.4%, respectively. A nomogram was established using age, ferritin and D-dimer to predict the risk of 28-day mortality.
Thrombo-inflammatory parameters provide key information on the severity and prognosis of COVID-19 and can be used as references for clinical treatment to correct inflammatory and coagulation abnormalities.
炎症和高凝状态在预测2019冠状病毒病（COVID-19）预后中的作用尚不清楚。
招募了2020年1月28日至2020年3月4日在武汉同济医院被诊断为COVID-19的成年患者。收集相关参数的数据。采用单因素分析和多变量二元逻辑回归来探索危重症和死亡率的预测因素。
分别有199例和44例患者纳入训练集和测试集。铁蛋白、肿瘤坏死因子-α和D-二聚体升高以及白蛋白浓度降低与疾病严重程度相关。年龄较大、铁蛋白升高和白细胞介素-6升高与28天死亡率相关。FAD-85评分定义为年龄+0.01×铁蛋白+D-二聚体，用于预测死亡风险。FAD-85的敏感性、特异性和准确性分别为86.4%、81.8%和86.4%。使用年龄、铁蛋白和D-二聚体建立了列线图来预测28天死亡风险。
血栓炎症参数提供了关于COVID-19严重程度和预后的关键信息，可作为临床治疗纠正炎症和凝血异常的参考。
