Liang Ying, Wang Qiwen, Zhao Yuli, Niu Xuedong, Chen Yue, Chen Xilu, Wang Yali, Zhou Xuwei, Xu Zhuang, Wu Shimin
Clin Lab. 2020 Nov 1;66(11). doi: 10.7754/Clin.Lab.2020.200660.
To investigate the clinical value of multi-index combined detection in the diagnosis of new coronavirus disease 2019 (COVID-19).
A total of 63 laboratory confirmed patients treated in our hospital were selected as the COVID-19 group, including 28 severe patients and 35 non-severe patients. Another 50 healthy subjects undergoing physical examination simultaneously were selected as the healthy group. Here we performed a study on the laboratory characteristics and explored their efficacy for diagnosis of the disease.
Compared with healthy people, the abnormal indicators of patients with COVID-19 are low levels of lymphocytes (LYM), red blood cells (RBC), hemoglobin (HGB), platelets (PLT), total protein (TP), and albumin (ALB), and high levels of monocytes (MON), aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), and C-reactive protein (CRP). The level of MON and CRP in severe patients were significantly increased compared with non-severe pneumonia patients, and indicators such as LYM and ALB were significantly reduced (p < 0.05). The sensitivity and specificity of the combined detection of LYM, MON, RBC, HGB, PLT, TP, ALB, AST, GGT, and CRP was 97.7% and 91.7%, which was higher than the single item (p < 0.05). The sensitivity and specificity of combined detection of LYM, MON, ALB, and CRP to predict the severity of COVID-19 were 96.4% and 73.0%, which were higher than those of separate detections (p < 0.05).
The index of LYM, MON, RBC, HGB, PLT, TP, ALB, AST, GGT, and CRP can be used for the diagnosis of new COVID-19, and the indicators of LYM, MON, ALB, and CRP may be predictors of severe pneumonia. The combined detection of the laboratory indexes can diagnose COVID-19 and predict the severity more effectively and accurately.
探讨多指标联合检测在2019年新型冠状病毒病（COVID-19）诊断中的临床价值。
选取我院收治的63例实验室确诊患者作为COVID-19组，其中重症患者28例，非重症患者35例。另选取同期进行体检的50例健康受试者作为健康组。在此对实验室特征进行研究，并探讨其对疾病诊断的效能。
与健康人相比，COVID-19患者的异常指标为淋巴细胞（LYM）、红细胞（RBC）、血红蛋白（HGB）、血小板（PLT）、总蛋白（TP）和白蛋白（ALB）水平降低，单核细胞（MON）、天冬氨酸转氨酶（AST）、γ-谷氨酰转肽酶（GGT）和C反应蛋白（CRP）水平升高。重症患者的MON和CRP水平与非重症肺炎患者相比显著升高，LYM和ALB等指标显著降低（p<0.05）。LYM、MON、RBC、HGB、PLT、TP、ALB、AST、GGT和CRP联合检测的灵敏度和特异度分别为97.7%和91.7%，高于单项检测（p<0.05）。LYM、MON、ALB和CRP联合检测预测COVID-19严重程度的灵敏度和特异度分别为96.4%和73.0%，高于单独检测（p<0.05）。
LYM、MON、RBC、HGB、PLT、TP、ALB、AST、GGT和CRP指标可用于新型COVID-19的诊断，LYM、MON、ALB和CRP指标可能是重症肺炎的预测指标。实验室指标联合检测可更有效、准确地诊断COVID-19并预测严重程度。
