Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Health Science University Turkey, Ankara, Turkey.
Epidemiol Infect. 2020 Nov 5;148:e272. doi: 10.1017/S095026882000271X.
SARS-CoV-2, the causative agent of coronavirus disease 19 (COVID-19), was identified in Wuhan, China. Since then, the novel coronavirus started to be compared to influenza. The haematological parameters and inflammatory indexes are associated with severe illness in COVID-19 patients. In this study, the laboratory data of 120 COVID-19 patients, 100 influenza patients and 61 healthy controls were evaluated. Lower lymphocytes, eosinophils, basophils, platelets and higher delta neutrophil index (DNI), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were found in COVID-19 and influenza groups compared to healthy controls. The eosinophils, lymphocytes and PLR made the highest contribution to differentiate COVID-19 patients from healthy controls (area under the curves (AUCs): 0.819, 0.817 and 0.716, respectively; P-value is <0.0001 for all). The NLR, the optimal cut-off value was 3.58, which resulted in a sensitivity of 30.8 and a specificity of 100 (AUC: 0.677, P < 0.0001). Higher leucocytes, neutrophils, DNI, NLR, PLR and lower lymphocytes, red blood cells, haemoglobin, haematocrit levels were found in severe patients at the end of treatment. Nonsevere patients showed an upward trend for lymphocytes, eosinophils and platelets, and a downward trend for neutrophils, DNI, NLR and PLR. However, there was an increasing trend for eosinophils, platelets and PLR in severe patients. In conclusion, NLR and PLR can be used as biomarkers to distinguish COVID-19 patients from healthy people and to predict the severity of COVID-19. The increasing value of PLR during follow-up may be more useful compared to NLR to predict the disease severity.
SARS-CoV-2,即导致 2019 年冠状病毒病(COVID-19)的病原体,在中国武汉被发现。自那时以来,新型冠状病毒开始与流感进行比较。COVID-19 患者的血液学参数和炎症指标与重症疾病相关。在这项研究中,评估了 120 名 COVID-19 患者、100 名流感患者和 61 名健康对照者的实验室数据。与健康对照组相比,COVID-19 和流感组的淋巴细胞、嗜酸性粒细胞、嗜碱性粒细胞、血小板较低,而中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和 delta 中性粒细胞指数(DNI)较高。嗜酸性粒细胞、淋巴细胞和 PLR 对区分 COVID-19 患者和健康对照组的贡献最大(曲线下面积(AUC):0.819、0.817 和 0.716;所有 P 值均 <0.0001)。NLR 的最佳截断值为 3.58,其灵敏度为 30.8%,特异性为 100%(AUC:0.677,P < 0.0001)。在治疗结束时,重症患者的白细胞、中性粒细胞、DNI、NLR、PLR 较高,而淋巴细胞、红细胞、血红蛋白、红细胞压积水平较低。非重症患者的淋巴细胞、嗜酸性粒细胞和血小板呈上升趋势,而中性粒细胞、DNI、NLR 和 PLR 呈下降趋势。然而,重症患者的嗜酸性粒细胞、血小板和 PLR 呈上升趋势。总之,NLR 和 PLR 可作为生物标志物来区分 COVID-19 患者和健康人群,并预测 COVID-19 的严重程度。与 NLR 相比,PLR 在随访期间的升高值可能更有助于预测疾病的严重程度。