Ferrari Davide, Seveso Andrea, Sabetta Eleonora, Ceriotti Daniele, Carobene Anna, Banfi Giuseppe, Locatelli Massimo, Cabitza Federico
SCVSA Department, University of Parma, Parma, Italy.
Laboratory Medicine Service, San Raffaele Hospital, Milan, Italy.
Diagnosis (Berl). 2020 Nov 18;7(4):387-394. doi: 10.1515/dx-2020-0095.
Objectives The pandemic COVID-19 currently reached 213 countries worldwide with nearly 9 million infected people and more than 460,000 deaths. Although several Chinese studies, describing the laboratory findings characteristics of this illness have been reported, European data are still scarce. Furthermore, previous studies often analyzed the averaged laboratory findings collected during the entire hospitalization period, whereas monitoring their time-dependent variations should give more reliable prognostic information. Methods We analyzed the time-dependent variations of 14 laboratory parameters in two groups of COVID-19 patients with, respectively, a positive (40 patients) or a poor (42 patients) outcome, admitted to the San Raffaele Hospital (Milan, Italy). We focused mainly on laboratory parameters that are routinely tested, thus, prognostic information would be readily available even in low-resource settings. Results Statistically significant differences between the two groups were observed for most of the laboratory findings analyzed. We showed that some parameters can be considered as early prognostic indicators whereas others exhibit statistically significant differences only at a later stage of the disease. Among them, earliest indicators were: platelets, lymphocytes, lactate dehydrogenase, creatinine, alanine aminotransferase, C-reactive protein, white blood cells and neutrophils. Conclusions This longitudinal study represents, to the best of our knowledge, the first study describing the laboratory characteristics of Italian COVID-19 patients on a normalized time-scale. The time-dependent prognostic value of the laboratory parameters analyzed in this study can be used by clinicians for the effective treatment of the patients and for the proper management of intensive care beds, which becomes a critical issue during the pandemic peaks.
目标 目前，新型冠状病毒肺炎（COVID-19）大流行已波及全球213个国家，感染人数近900万，死亡人数超过46万。尽管已有多项中国研究报告了该疾病的实验室检查结果特征，但欧洲的数据仍然匮乏。此外，以往的研究通常分析的是整个住院期间收集的实验室检查结果平均值，而监测其随时间的变化应该能提供更可靠的预后信息。方法 我们分析了意大利米兰圣拉斐尔医院收治的两组COVID-19患者（分别为预后良好组40例和预后不良组42例）14项实验室参数随时间的变化。我们主要关注常规检测的实验室参数，因此，即使在资源匮乏的环境中也能 readily 获得预后信息。结果 在所分析的大多数实验室检查结果中，两组之间观察到统计学上的显著差异。我们发现一些参数可被视为早期预后指标，而其他参数仅在疾病后期表现出统计学上的显著差异。其中，最早出现变化的指标有：血小板、淋巴细胞、乳酸脱氢酶、肌酐、丙氨酸转氨酶、C反应蛋白、白细胞和中性粒细胞。结论 据我们所知，这项纵向研究是第一项在标准化时间尺度上描述意大利COVID-19患者实验室特征的研究。本研究中分析的实验室参数的时间依赖性预后价值可供临床医生用于有效治疗患者和合理管理重症监护床位，这在疫情高峰期是一个关键问题。
