The Affiliated Infectious Hospital of Soochow University, 10, Guangqian Road, Suzhou, Jiangsu, P. R. China, 215000.
The Fifth People's Hospital of Suzhou, Suzhou, China.
BMC Infect Dis. 2020 Oct 12;20(1):747. doi: 10.1186/s12879-020-05468-8.
Sudden exacerbations and respiratory failure are major causes of death in patients with severe coronavirus disease 2019(COVID-19) pneumonia, but indicators for the prediction and treatment of severe patients are still lacking.
A retrospective analysis of 67 collected cases was conducted and included approximately 67 patients with COVID-19 pneumonia who were admitted to the Suzhou Fifth People's Hospital from January 1, 2020 to February 8, 2020. The epidemiological, clinical and imaging characteristics as well as laboratory data of the 67 patients were analyzed.
The study found that fibrinogen (FIB) was increased in 45 (65.2%) patients, and when FIB reached a critical value of 4.805 g/L, the sensitivity and specificity、DA, helping to distinguish general and severe cases, were 100 and 14%、92.9%, respectively, which were significantly better than those for lymphocyte count and myoglobin. Chest CT images indicated that the cumulative number of lung lobes with lesions in severe patients was significantly higher than that in general patients (P < 0.05), and the cumulative number of lung lobes with lesions was negatively correlated with lymphocyte count and positively correlated with myoglobin and FIB. Our study also found that there was no obvious effect of hormone therapy in patients with severe COVID-19.
Based on the retrospective analysis, FIB was found to be increased in severe patients and was better than lymphocyte count and myoglobin in distinguishing general and severe patients. The study also suggested that hormone treatment has no significant effect on COVID-19.
新冠肺炎（COVID-19）重症患者的主要死亡原因是病情突然恶化和呼吸衰竭，但仍缺乏针对重症患者的预测和治疗指标。
对 67 例采集病例进行回顾性分析，纳入 2020 年 1 月 1 日至 2 月 8 日期间苏州市第五人民医院收治的 COVID-19 肺炎患者约 67 例。分析 67 例患者的流行病学、临床和影像学特征及实验室数据。
研究发现，45 例（65.2%）患者纤维蛋白原（FIB）升高，当 FIB 达到 4.805g/L 临界值时，灵敏度和特异度、DA，有助于鉴别普通型和重型，分别为 100%和 14%、92.9%，均显著优于淋巴细胞计数和肌红蛋白。胸部 CT 图像显示，重症患者肺部病变累及肺叶数明显高于普通型患者（P<0.05），肺部病变累及肺叶数与淋巴细胞计数呈负相关，与肌红蛋白和 FIB 呈正相关。本研究还发现，重症 COVID-19 患者激素治疗效果不明显。
基于回顾性分析，发现重症患者 FIB 升高，在鉴别普通型和重症患者方面优于淋巴细胞计数和肌红蛋白。研究还提示激素治疗对 COVID-19 无明显效果。
