Sulejmani Adela, Galimberti Elisa, Giacobone Chiara, Milano Antonio, Scopetta Elena, Intra Jari, Falbo Rosanna, Sarto Cecilia, Leoni Valerio, Brambilla Paolo
Laboratory of Clinical Chemistry, Hospital of Desio and Monza, ASST-Monza and School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
Scand J Clin Lab Invest. 2021 Feb;81(1):18-23. doi: 10.1080/00365513.2020.1846211. Epub 2021 Jan 6.
The correlation of clinical, radiological and laboratory findings of patients at admission in the Emergency Department (ED) with clinical severity and risk of mortality was investigated. Adult coronavirus disease 2019 (COVID-19) patients hospitalized in March 2020 in Desio Hospital, Lombardy, were retrospectively included in the study, and categorized in terms of disease severity and adverse outcome. Out of the 175 patients enrolled, 79% presented one or more comorbidities, with cardiovascular disease being the most frequent (62%). More than half of the patients showed lymphocytopenia and 20% thrombocytopenia. The patients in the severe group presented higher absolute neutrophil count (ANC), C-reactive protein (CRP), AST, LDH, procalcitonin (PCT) and BUN values compared to the non-severe group ( < .05). Increased odds of mortality associated with older age (OR = 22.43; 95% CI 5.22-96.27), partial pressure of oxygen (PaO)/fraction of inspired oxygen (FIO) ratio < 200 (OR = 4.97; 95% CI 1.55-15.84), clinical severity (OR = 21.32; 95% CI 2.27-200.13), creatinine > 106.08 µmol/L (OR = 2.87; 95% CI 1.04-7.92) and creatine kinase > 2.90 µkat/L (OR = 3.80; 95% CI 1.31-10.9) were observed on admission ( < .05). The above findings may contribute to identify early risk factors of poor prognosis, and to select the most appropriate management for patients.
研究了急诊科（ED）患者入院时的临床、放射学和实验室检查结果与临床严重程度和死亡风险之间的相关性。回顾性纳入了2020年3月在伦巴第大区德西奥医院住院的成年2019冠状病毒病（COVID-19）患者，并根据疾病严重程度和不良结局进行分类。在纳入的175例患者中，79%患有一种或多种合并症，其中心血管疾病最为常见（62%）。超过一半的患者出现淋巴细胞减少，20%出现血小板减少。与非重症组相比，重症组患者的绝对中性粒细胞计数（ANC）、C反应蛋白（CRP）、谷草转氨酶（AST）、乳酸脱氢酶（LDH）、降钙素原（PCT）和血尿素氮（BUN）值更高（P<0.05）。入院时观察到，年龄较大（OR = 22.43；95%CI 5.22-96.27）、氧分压（PaO）/吸入氧分数（FIO）比值<200（OR = 4.97；95%CI 1.55-15.84）、临床严重程度（OR = 21.32；95%CI 2.27-200.13）、肌酐>106.08µmol/L（OR = 2.87；95%CI 1.04-7.92）和肌酸激酶>2.90µkat/L（OR = 3.80；95%CI 1.31-10.9）与死亡几率增加相关（P<0.05）。上述发现可能有助于识别预后不良的早期危险因素，并为患者选择最合适的治疗方案。
