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回顾性研究住院 COVID-19 患者的临床特征及其与疾病严重程度的关系。

Retrospective Study of Clinical Features of COVID-19 in Inpatients and Their Association with Disease Severity.

机构信息

Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, China (mainland).

Department of Clinical Laboratory, Chongqing University Center Hospital, Chongqing, China (mainland).

出版信息

Med Sci Monit. 2020 Dec 21;26:e927674. doi: 10.12659/MSM.927674.

Abstract

BACKGROUND The aim of this study was to analyze the clinical features and laboratory indices of patients with coronavirus disease (COVID-19) and explore their association with the severity of the disease. MATERIAL AND METHODS A total of 61 patients with COVID-19 were divided into groups with common symptoms and with severe diseases, and clinical data were collected to analyze and compare the differences between them. RESULTS In patients with severe COVID-19, compared with the common group, lymphocyte count and albumin levels were lower, and aspartate aminotransferase (AST), blood urea, blood creatinine, lactate dehydrogenase (LDH), and C-reactive protein (CRP) levels, and prothrombin time (PT) were elevated (all P<0.05). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and C-reactive protein-to-albumin ratio (CAR) were significantly elevated in the severe group compared with the group with common symptoms; however, the lymphocyte-to-monocyte ratio (LMR) was significantly reduced (P<0.05). Univariate logistic regression showed that lower lymphocyte count, prolonged PT, elevated CRP and LDH levels, and elevated NLR, PLR, MPVLR, and CAR were risk factors for COVID-19 severity (P<0.05). Multivariate logistic regression showed that elevated CRP levels (odds ratio [OR], 0.028; 95% confidence interval [CI]: 0.002-0.526; P=0.017), prolonged PT (OR, 0.014; 95% CI: 0.001-0.341; P=0.09), and an MPVLR >8.9 (OR, 0.026; 95% CI: 0.002-0.349; P=0.006) were independent risk factors for COVID-19 severity. CONCLUSIONS Elevated CRP and prolonged PT, and an MPVLR >8.9 were independent risk factors for COVID-19 severity.

摘要

背景

本研究旨在分析新型冠状病毒病(COVID-19)患者的临床特征和实验室指标,并探讨其与疾病严重程度的关系。

材料与方法

共纳入 61 例 COVID-19 患者,分为普通症状组和重症组,收集临床资料进行分析比较。

结果

重症 COVID-19 患者的淋巴细胞计数和白蛋白水平较普通组降低,天门冬氨酸氨基转移酶(AST)、尿素、血肌酐、乳酸脱氢酶(LDH)、C 反应蛋白(CRP)和凝血酶原时间(PT)水平升高(均 P<0.05)。重症组的中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血小板平均体积与淋巴细胞比值(MPVLR)和 CRP 与白蛋白比值(CAR)显著高于普通症状组,而淋巴细胞与单核细胞比值(LMR)显著降低(P<0.05)。单因素 logistic 回归分析显示,淋巴细胞计数降低、PT 延长、CRP 和 LDH 水平升高、NLR、PLR、MPVLR 和 CAR 升高是 COVID-19 严重程度的危险因素(P<0.05)。多因素 logistic 回归分析显示,CRP 水平升高(OR=0.028,95%CI:0.002-0.526,P=0.017)、PT 延长(OR=0.014,95%CI:0.001-0.341,P=0.09)和 MPVLR>8.9(OR=0.026,95%CI:0.002-0.349,P=0.006)是 COVID-19 严重程度的独立危险因素。

结论

CRP 水平升高、PT 延长和 MPVLR>8.9 是 COVID-19 严重程度的独立危险因素。

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