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血液学变化可预测 COVID-19 恢复期患者的临床结局。

Hematologic changes predict clinical outcome in recovered patients with COVID-19.

机构信息

Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, People's Republic of China.

Eighth Batch Chongqing Medical Aid Team to Wuhan City of Hubei Province, Chongqing, People's Republic of China.

出版信息

Ann Hematol. 2021 Mar;100(3):675-689. doi: 10.1007/s00277-021-04426-x. Epub 2021 Feb 1.

Abstract

2019 coronavirus disease (COVID-19) presents as a newly recognized pneumonia that has brought about a global pandemic and is increasingly considered as a systemic illness. We investigated the clinical and laboratory features of recovered COVID-19 patients without pre-existing hematologic diseases at Wuhan No. 1 Hospital. Fifty-nine male and 68 female Chinese patients were included with the median age at 64 years in the present study. Eosinopenia (37.80%), monocytosis (51.97%), lymphocytopenia (25.20%), and anemia (51.97%) were the most common hematologic findings in our cohort, particularly in severe or critically ill COVID-19. The levels of changes in leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, hemoglobin levels, mean corpuscular volume (MCV), and mean cell hemoglobin concentration (MCHC) are overall associated with lung involvement, oxygen demand, and disease activity. However, changes of eosinophils (end hospitalization-baseline) (coefficients = 10.32; 95% CI = 1.03-19.60, P = 0.03) and basophils (Max - Min) (coefficients = 71.43; 95% CI = 8.55-134.31, P = 0.03) were independent predictors of delayed recovery in the hospital by the multivariate analysis in this recovered population. A variety of hematologic changes are associated with the severity and clinical outcome of recovered COVID-19 patients, which warrants further exploration of their underlying mechanisms.

摘要

2019 冠状病毒病 (COVID-19) 表现为一种新出现的肺炎,已在全球范围内引发大流行,并被越来越多地认为是一种全身性疾病。我们调查了武汉第一医院无血液系统疾病的 COVID-19 康复患者的临床和实验室特征。本研究共纳入 59 名男性和 68 名女性中国患者,中位年龄为 64 岁。本研究中,最常见的血液学发现是嗜酸性粒细胞减少症(37.80%)、单核细胞增多症(51.97%)、淋巴细胞减少症(25.20%)和贫血(51.97%),特别是在严重或危重症 COVID-19 患者中。白细胞、中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞、血小板、血红蛋白水平、平均红细胞体积(MCV)和平均红细胞血红蛋白浓度(MCHC)的变化水平总体上与肺受累、氧需求和疾病活动度相关。然而,在多元分析中,住院期间的嗜酸性粒细胞(住院结束-基线)(系数=10.32;95%CI=1.03-19.60,P=0.03)和嗜碱性粒细胞(最大-最小)(系数=71.43;95%CI=8.55-134.31,P=0.03)的变化与该康复人群的住院时间延长相关。在 COVID-19 康复患者中,各种血液学变化与疾病的严重程度和临床结局相关,这值得进一步探讨其潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af26/7848253/821769ec0fa4/277_2021_4426_Fig1_HTML.jpg

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