年龄增长、中性粒细胞与淋巴细胞比值（NLR）和白细胞计数与 COVID-19 死亡率升高相关。
Increased age, neutrophil-to-lymphocyte ratio (NLR) and white blood cells count are associated with higher COVID-19 mortality.
机构信息
Emergency Department, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Student research Committee, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
出版信息
Am J Emerg Med. 2021 Feb;40:11-14. doi: 10.1016/j.ajem.2020.12.003. Epub 2020 Dec 4.
OBJECTIVE
Coronavirus disease 19 (COVID-19) caused by the highly pathogenic SARS-CoV-2, was first reported from Wuhan, China, in December 2019. The present study assessed possible associations between one-month mortality and demographic data, SpO, underlying diseases and laboratory findings, in COVID-19 patients. Also, since recent studies on COVID-19, have focused on Neutrophil-to-lymphocyte ratio (NLR) as an independent risk factor of the in-hospital death and a significant prognostic biomarker of outcomes in critically ill patients, in this study, we assessed predictive potential of this factor in terms of one-month mortality.
METHODS
Patients admitted to Imam Reza hospital, affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, from March to June 2020, with positive RT-PCR results for SARS-CoV-2, were included in this study. Kaplan-Meier survival analysis and Cox proportional hazard model were used to respectively estimate one-month mortality since admission and determine factors associated with one-month mortality.
RESULTS
In this retrospective cohort study, 219 patients were included (137 men and 82 women (mean age 58.2 ± 16 and 57 ± 17.3 years old, respectively)). Hypertension, ischemic heart disease and diabetes were respectively the most common comorbidities. Among these patients, 63 patients were admitted to the ICU and 31 deaths occurred during one-month follow-up. With respect to mean peripheral capillary oxygen saturation (SpO), 142 patients had SpO ≤ 90%. Based on our analysis, older age and increased Neutrophil-to-lymphocyte ratio (NLR), and White blood cells (WBC) count were associated with increased risk of one-month mortality. Patients with SpO ≤ 90% had a 3.8-fold increase in risk of one-month death compared to those with SpO > 90%, although the difference did not reach a significant level.
CONCLUSION
Multivariate analysis introduced age, WBC count, and NLR as predictors of one-month mortality in COVID-19 patients.
目的
由高致病性 SARS-CoV-2 引起的 2019 年冠状病毒病（COVID-19）最初于 2019 年 12 月在中国武汉报告。本研究评估了 COVID-19 患者的一个月死亡率与人口统计学数据、SpO、潜在疾病和实验室发现之间的可能关联。此外，由于最近关于 COVID-19 的研究将中性粒细胞与淋巴细胞比值（NLR）作为住院死亡的独立危险因素，并作为危重症患者结局的重要预后生物标志物，因此在这项研究中，我们评估了该因素对一个月死亡率的预测潜力。
方法
本回顾性队列研究纳入了 2020 年 3 月至 6 月期间入住伊朗马什哈德马什哈德医科大学伊玛目礼萨医院且 SARS-CoV-2 的 RT-PCR 结果为阳性的患者。分别使用 Kaplan-Meier 生存分析和 Cox 比例风险模型来估计入院后一个月的死亡率以及确定与一个月死亡率相关的因素。
结果
在这项回顾性队列研究中，共纳入 219 例患者（男性 137 例，女性 82 例（平均年龄 58.2±16 岁和 57±17.3 岁））。高血压、缺血性心脏病和糖尿病分别是最常见的合并症。在这些患者中，有 63 例患者入住 ICU，有 31 例患者在一个月的随访期间死亡。根据平均外周毛细血管血氧饱和度（SpO），有 142 例患者的 SpO≤90%。根据我们的分析，年龄较大、中性粒细胞与淋巴细胞比值（NLR）和白细胞（WBC）计数增加与一个月死亡率增加相关。与 SpO>90%的患者相比，SpO≤90%的患者一个月死亡的风险增加了 3.8 倍，尽管差异没有达到显著水平。
结论
多变量分析将年龄、WBC 计数和 NLR 引入 COVID-19 患者一个月死亡率的预测因素。
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