绝对淋巴细胞计数、铁蛋白、C 反应蛋白和乳酸脱氢酶预测 COVID-19 患者早期有创通气。
Absolute Lymphocytes, Ferritin, C-Reactive Protein, and Lactate Dehydrogenase Predict Early Invasive Ventilation in Patients With COVID-19.
机构信息
Haematology Department, Hospital de la Santa Creu i Sant Pau, Sant Pau Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
出版信息
Lab Med. 2021 Mar 15;52(2):141-145. doi: 10.1093/labmed/lmaa105.
OBJECTIVE
Early detection of patients with COVID-19 who will need mechanical invasive ventilation (MIV) may aid in delivering proper care and optimizing the use of limited resources.
METHODS
In this single-center retrospective observational study, we aimed to identify simple laboratory parameters that in combination with ferritin (a surrogate marker of severe inflammation) may help predict early (first 48 hours) MIV. A total of 160 patients with COVID-19 in whom serum ferritin, absolute lymphocyte count (ALC), platelet count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) had been analyzed at admission were included.
RESULTS
We found that ferritin, LDH, ALC, and CRP predicted with 88% accuracy the probability of early MIV. Results indicated that LDH showed the greater area under the curve (AUC), with a value of 89.1%. Using the AUC, we established cutoff values for clinical application. Finally, we developed a classification tree based on LDH for its clinical use.
CONCLUSION
Ferritin, LDH, ALC, and CRP predict with 88% accuracy the probability of early MIV.
目的
早期检测需要机械通气（MIV）的 COVID-19 患者可能有助于提供适当的护理和优化有限资源的使用。
方法
在这项单中心回顾性观察性研究中，我们旨在确定简单的实验室参数，这些参数与铁蛋白（严重炎症的替代标志物）结合使用，可能有助于预测早期（前 48 小时）MIV。共纳入 160 名 COVID-19 患者，他们在入院时分析了血清铁蛋白、绝对淋巴细胞计数（ALC）、血小板计数、C 反应蛋白（CRP）和乳酸脱氢酶（LDH）。
结果
我们发现铁蛋白、LDH、ALC 和 CRP 以 88%的准确度预测了早期 MIV 的概率。结果表明，LDH 的曲线下面积（AUC）更大，为 89.1%。使用 AUC，我们确定了用于临床应用的截断值。最后，我们基于 LDH 开发了一个分类树，用于其临床应用。
结论
铁蛋白、LDH、ALC 和 CRP 以 88%的准确度预测了早期 MIV 的概率。
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