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外周血炎症标志物在预测 COVID-19 患者预后中的作用。与甲型流感的一些差异。

Peripheral blood inflammatory markers in predicting prognosis in patients with COVID-19. Some differences with influenza A.

机构信息

Department of Clinical Laboratory, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.

Hubei Academy of Traditional Chinese Medicine, Wuhan, China.

出版信息

J Clin Lab Anal. 2021 Jan;35(1):e23657. doi: 10.1002/jcla.23657. Epub 2020 Nov 22.

Abstract

BACKGROUND

To evaluate the ability of peripheral blood inflammatory markers in predicating the typing of COVID-19, prognosis, and some differences between COVID-19 and influenza A patients.

METHODS

Clinical data on 285 cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms. Additional 446 Influenza A outpatients' hematologic data were enrolled for comparison.

RESULTS

NLR, SII, RLR, PLR, HsCRP, and IL-6 were significant higher and LMR was lower in severe COVID-19 patients than in mild COVID-19 patients (p < .001). PLR and LMR were lower in the individuals with influenza A than those with COVID-19 (p < .01). COVID-19 patients with higher levels of NLR, SII, RLR, PLR, HsCRP, and IL-6 and lower LMR were significantly associated with the severe type. AUC of NLR (0.76) was larger while the specificity of IL-6 (86%) and sensitivity of HsCRP (89%) were higher than other inflammatory markers in predicating the typing of COVID-19. PT had obvious correlation with all the inflammatory markers except RPR. NLR showed positive correlations with AST, TP, BUN, CREA, PT, and D-dimer. Patients with high IL-6 levels have a relatively worse prognosis (HR = 2.30).

CONCLUSION

Peripheral blood inflammatory markers reflected the intensity of inflammation and associated with severity of COVID-19.NLR was more useful to predict severity as well as IL-6 to predict prognosis of COVID-19. PLR and LMR were initially found to be higher in SARS-CoV-2 virus-infected group than in influenza A.

摘要

背景

评估外周血炎症标志物预测 COVID-19 分型、预后的能力,以及 COVID-19 与甲型流感患者之间的差异。

方法

根据预先设计的标准化数据收集表格,从武汉当地医院的电子病历中获取了 285 例经实验室确诊为 SARS-CoV-2 感染的病例的临床数据。还纳入了 446 例甲型流感门诊患者的血液学数据进行比较。

结果

重症 COVID-19 患者的 NLR、SII、RLR、PLR、HsCRP 和 IL-6 明显高于轻症 COVID-19 患者(p<0.001)。PLR 和 LMR 在甲型流感患者中低于 COVID-19 患者(p<0.01)。NLR、SII、RLR、PLR、HsCRP 和 IL-6 水平较高且 LMR 较低的 COVID-19 患者与重型患者显著相关。NLR(0.76)的 AUC 较大,而 IL-6(86%)的特异性和 HsCRP(89%)的敏感性在预测 COVID-19 分型方面均高于其他炎症标志物。PT 与除 RPR 外的所有炎症标志物均明显相关。NLR 与 AST、TP、BUN、CREA、PT 和 D-二聚体呈正相关。IL-6 水平较高的患者预后较差(HR=2.30)。

结论

外周血炎症标志物反映了炎症的强度,与 COVID-19 的严重程度相关。NLR 对预测严重程度,IL-6 对预测 COVID-19 预后更有用。PLR 和 LMR 最初发现在 SARS-CoV-2 病毒感染组中高于甲型流感组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/633d/7843254/d20c36af408c/JCLA-35-e23657-g001.jpg

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