Department of Critical Care Medicine, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China.
Third Batch Chongqing Medical Aid Team to Wuhan City of Hubei Province, Chongqing, P.R. China.
PLoS One. 2020 Oct 30;15(10):e0240751. doi: 10.1371/journal.pone.0240751. eCollection 2020.
This retrospective study investigated the implications of changes in blood parameters and cellular immune function in patients with Coronavirus Disease 2019 (COVID-19).
Records were reviewed of 85 patients admitted with COVID-19 between February 4 and 16, 2020. The primary outcome was in-hospital death.
Fourteen patients died. The baseline leukocyte count, neutrophil count and hemoglobin was significantly higher in non-survivors compared with survivors, while the reverse was true of lymphocyte count, platelet, PaO2/FiO2, CD3+ count and CD4+ count. The percentage of neutrophil count > 6.3×109/L in death group was significantly higher than that in survival group, and multivariate logistic regression showed neutrophil count > 6.3×109/L was independently associated with mortality. However, there were not significant difference in IgG, IgM, IgA, C3, C4 and the percentage of IgE > 100 IU/ml between the death group and survival group. Areas under the receiver operating characteristic curves of the following at baseline could significantly predict mortality: leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts.
For hospitalized patients with COVID-19, lymphocyte, CD3+ and CD4+ counts that marked decrease suggest a poor outcome. Admission neutrophil count > 6.3 ×109/L is independently associated with mortality. At admission, leukocyte, neutrophil, lymphocyte, CD3+ and CD4+ counts should receive added attention.
本回顾性研究探讨了新冠肺炎(COVID-19)患者血液参数和细胞免疫功能变化的意义。
回顾了 2020 年 2 月 4 日至 16 日期间因 COVID-19 入院的 85 例患者的记录。主要结局为住院期间死亡。
14 例患者死亡。与幸存者相比,非幸存者的白细胞计数、中性粒细胞计数和血红蛋白基线水平明显更高,而淋巴细胞计数、血小板、PaO2/FiO2、CD3+计数和 CD4+计数则相反。死亡组中性粒细胞计数>6.3×109/L 的比例明显高于存活组,多变量逻辑回归显示中性粒细胞计数>6.3×109/L 与死亡率独立相关。然而,死亡组和存活组之间 IgG、IgM、IgA、C3、C4 和 IgE>100 IU/ml 的百分比没有显著差异。以下基线时的受试者工作特征曲线下面积可显著预测死亡率:白细胞、中性粒细胞、淋巴细胞、CD3+和 CD4+计数。
对于住院的 COVID-19 患者,标记性减少的淋巴细胞、CD3+和 CD4+计数提示预后不良。入院时中性粒细胞计数>6.3×109/L 与死亡率独立相关。入院时,白细胞、中性粒细胞、淋巴细胞、CD3+和 CD4+计数应受到更多关注。