血红蛋白水平下降预示着 COVID-19 合并肺炎患者发生严重呼吸衰竭的风险增加。
Decrease in hemoglobin level predicts increased risk for severe respiratory failure in COVID-19 patients with pneumonia.
机构信息
Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan; Department of Respiratory Medicine, Kumamto City Hospital, 4-1-60 Higashi-machi, Higashi-ku, Kumamoto 862-8505, Japan.
Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan; Department of Respiratory Medicine, Kumamto City Hospital, 4-1-60 Higashi-machi, Higashi-ku, Kumamoto 862-8505, Japan.
出版信息
Respir Investig. 2021 Mar;59(2):187-193. doi: 10.1016/j.resinv.2020.10.009. Epub 2020 Nov 23.
BACKGROUND
In December 2019, the coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), emerged in Wuhan, China, and has since spread throughout the world. This study aimed to investigate the association between the change in laboratory markers during the three days after pneumonia diagnosis and severe respiratory failure in COVID-19 patients.
METHODS
Data of 23 COVID-19 patients with pneumonia, admitted to the Kumamoto City Hospital between February and April 2020 were retrospectively analyzed.
RESULTS
Among the 23 patients, eight patients received mechanical ventilation (MV) (MV group), and the remaining 15 comprised the non-MV group. The levels of hemoglobin (Hb) and albumin (Alb) decreased in the MV group during the three days after pneumonia diagnosis more than in the non-MV group (median Hb: 1.40 vs. -0.10 g/dL, P = 0.015; median Alb: 0.85 vs. -0.30 g/dL, P = 0.020). Univariate logistic regression analysis showed that the decrease in Hb was associated with receiving MV care (odds ratio: 0.313, 95% confidence interval: 0.100-0.976, P = 0.045). Receiver operating characteristic curve analyses showed that the optimal cut-off value for the decrease in Hb level was -1.25 g/dL, with sensitivity and specificity values of 0.867 and 0.750, respectively.
CONCLUSIONS
The decrease in Hb level during the short period after pneumonia diagnosis might be a predictor of worsening pneumonia in COVID-19 patients.
背景
2019 年 12 月，由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的冠状病毒病（COVID-19）在中国武汉出现，并已在全球范围内传播。本研究旨在探讨肺炎诊断后三天内实验室标志物的变化与 COVID-19 患者发生严重呼吸衰竭之间的关系。
方法
回顾性分析 2020 年 2 月至 4 月期间在熊本市医院住院的 23 例肺炎 COVID-19 患者的数据。
结果
在 23 例患者中，8 例患者接受了机械通气（MV）（MV 组），其余 15 例为非 MV 组。在肺炎诊断后的三天内，MV 组的血红蛋白（Hb）和白蛋白（Alb）水平下降幅度大于非 MV 组（中位数 Hb：1.40 与 -0.10 g/dL，P = 0.015；中位数 Alb：0.85 与 -0.30 g/dL，P = 0.020）。单因素 logistic 回归分析显示，Hb 下降与接受 MV 护理有关（比值比：0.313，95%置信区间：0.100-0.976，P = 0.045）。受试者工作特征曲线分析显示，Hb 水平下降的最佳截断值为-1.25 g/dL，其灵敏度和特异性分别为 0.867 和 0.750。
结论
肺炎诊断后短期 Hb 水平下降可能是 COVID-19 患者肺炎恶化的预测指标。
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