Department of Laboratory Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Department of Laboratory Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China.
Diagn Microbiol Infect Dis. 2021 Feb;99(2):115169. doi: 10.1016/j.diagmicrobio.2020.115169. Epub 2020 Oct 21.
We evaluated simple laboratory variables to discriminate COVID-19 from bacterial pneumonia or influenza and for the prospective grading of COVID-19. Multivariate logistic regression and receiver operating characteristic curve were used to estimate the diagnostic performance of the significant discriminating variables. A comparative analysis was performed with different severity. The leukocytosis (P = 0.017) and eosinopenia (P = 0.001) were discriminating variables between COVID-19 and bacterial pneumonia with area under the curve (AUC) of 0.778 and 0.825. Monocytosis (P = 0.003), the decreased lymphocyte-to-monocyte ratio (P < 0.001), and the increased neutrophil-to-lymphocyte ratio (NLR) (P = 0.028) were predictive of influenza with AUC of 0.723, 0.895, and 0.783, respectively. Serum amyloid protein, lactate dehydrogenase, CD3 cells, and the fibrinogen degradation products had a good correlation with the severity of COVID-19 graded by age (≥50) and NLR (≥3.13). Simple laboratory variables are helpful for rapid diagnosis on admission and hierarchical management of COVID-19 patients.
我们评估了简单的实验室变量，以区分 COVID-19 与细菌性肺炎或流感，并对 COVID-19 进行前瞻性分级。使用多元逻辑回归和接收者操作特征曲线来估计有意义的鉴别变量的诊断性能。进行了不同严重程度的比较分析。白细胞增多症（P=0.017）和嗜酸性粒细胞减少症（P=0.001）是 COVID-19 与细菌性肺炎之间的鉴别变量，曲线下面积（AUC）分别为 0.778 和 0.825。单核细胞增多症（P=0.003）、淋巴细胞与单核细胞比值降低（P<0.001）和中性粒细胞与淋巴细胞比值升高（NLR）（P=0.028）是流感的预测指标，AUC 分别为 0.723、0.895 和 0.783。血清淀粉样蛋白、乳酸脱氢酶、CD3 细胞和纤维蛋白原降解产物与年龄（≥50 岁）和 NLR（≥3.13）分级的 COVID-19 严重程度具有良好的相关性。简单的实验室变量有助于在入院时快速诊断和对 COVID-19 患者进行分层管理。
