Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
BMC Infect Dis. 2020 Dec 21;20(1):963. doi: 10.1186/s12879-020-05681-5.
COVID-19 is highly contagious, and the crude mortality rate could reach 49% in critical patients. Inflammation concerns on disease progression. This study analyzed blood inflammation indicators among mild, severe and critical patients, helping to identify severe or critical patients early.
In this cross-sectional study, 100 patients were included and divided into mild, severe or critical groups according to disease condition. Correlation of peripheral blood inflammation-related indicators with disease criticality was analyzed. Cut-off values for critically ill patients were speculated through the ROC curve.
Significantly, disease severity was associated with age (R = -0.564, P < 0.001), interleukin-2 receptor (IL2R) (R = -0.534, P < 0.001), interleukin-6 (IL-6) (R = -0.535, P < 0.001), interleukin-8 (IL-8) (R = -0.308, P < 0.001), interleukin-10 (IL-10) (R = -0.422, P < 0.001), tumor necrosis factor α (TNFα) (R = -0.322, P < 0.001), C-reactive protein (CRP) (R = -0.604, P < 0.001), ferroprotein (R = -0.508, P < 0.001), procalcitonin (R = -0.650, P < 0.001), white cell counts (WBC) (R = -0.54, P < 0.001), lymphocyte counts (LC) (R = 0.56, P < 0.001), neutrophil count (NC) (R = -0.585, P < 0.001) and eosinophil counts (EC) (R = 0.299, P < 0.001). With IL2R > 793.5 U/mL or CRP > 30.7 ng/mL, the progress of COVID-19 to critical stage should be closely observed and possibly prevented.
Inflammation is closely related to severity of COVID-19, and IL-6 and TNFα might be promising therapeutic targets.
COVID-19 具有高度传染性，重症患者的粗死亡率可达到 49%。炎症是影响疾病进展的关注点。本研究分析了轻症、重症和危重症患者的血液炎症指标，有助于早期识别重症或危重症患者。
本横断面研究纳入 100 例患者，根据病情分为轻症、重症或危重症组。分析外周血炎症相关指标与疾病危重程度的相关性。通过 ROC 曲线推测危重症患者的截断值。
疾病严重程度与年龄（R=-0.564，P<0.001）、白细胞介素-2 受体（IL-2R）（R=-0.534，P<0.001）、白细胞介素-6（IL-6）（R=-0.535，P<0.001）、白细胞介素-8（IL-8）（R=-0.308，P<0.001）、白细胞介素-10（IL-10）（R=-0.422，P<0.001）、肿瘤坏死因子-α（TNF-α）（R=-0.322，P<0.001）、C 反应蛋白（CRP）（R=-0.604，P<0.001）、铁蛋白（R=-0.508，P<0.001）、降钙素原（PCT）（R=-0.650，P<0.001）、白细胞计数（WBC）（R=-0.54，P<0.001）、淋巴细胞计数（LC）（R=0.56，P<0.001）、中性粒细胞计数（NC）（R=-0.585，P<0.001）和嗜酸性粒细胞计数（EC）（R=0.299，P<0.001）显著相关。IL-2R>793.5 U/mL 或 CRP>30.7ng/mL 时，COVID-19 进展为危重症阶段应密切观察并可能预防。
炎症与 COVID-19 严重程度密切相关，IL-6 和 TNF-α可能是有前途的治疗靶点。
