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鉴定与 COVID-19 严重程度相关的常规血液和凝血测试中的参数。

Identification of parameters in routine blood and coagulation tests related to the severity of COVID-19.

机构信息

Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.

Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.

出版信息

Int J Med Sci. 2021 Jan 14;18(5):1207-1215. doi: 10.7150/ijms.47494. eCollection 2021.

Abstract

This study aimed to identify the predictive value of simple markers in routine blood and coagulation tests for the severity of coronavirus disease 2019 (COVID-19). A total of 311 consecutive COVID-19 patients, including 281 patients with mild/moderate COVID-19 and 30 patients with severe/life-threatening COVID-19, were retrospectively enrolled. Logistic modeling and ROC curve analyses were used to assess the indexes for identifying disease severity. Lymphocyte and eosinophil counts of COVID-19 patients in the severe/life-threatening group were significantly lower than those of patients in the mild/moderate group (P < 0.001). Coagulation parameters, high-sensitivity C-reactive protein (hsCRP) levels and procalcitonin levels were higher in the severe/life-threatening group compared with the mild/moderate group (all P < 0.05). Univariate and multivariate logistic models revealed that hsCRP and fibrinogen degradation products (FDPs) were predictors of severe COVID-19 (OR = 1.072, P = 0.036; and OR = 1.831, P = 0.036, respectively). The AUROCs of hsCRP and FDP for predicting severe/life-threatening COVID-19 were 0.850 and 0.766, respectively. The optimal cutoffs of hsCRP and FDP for the severe/life-threatening type of COVID-19 were 22.41 mg/L and 0.95 µg/ml, respectively. Serum CRP and FDP levels are positively related to the severity of COVID-19. This finding indicates that CRP and FDP levels may potentially be used as early predictors for severe illness and help physicians triage numerous patients in a short time.

摘要

本研究旨在确定常规血液和凝血检测中的简单标志物对 2019 年冠状病毒病(COVID-19)严重程度的预测价值。共回顾性纳入 311 例连续 COVID-19 患者,其中 281 例为轻症/中度 COVID-19 患者,30 例为重症/危及生命 COVID-19 患者。采用逻辑建模和 ROC 曲线分析评估识别疾病严重程度的指标。重症/危及生命组 COVID-19 患者的淋巴细胞和嗜酸性粒细胞计数明显低于轻症/中度组(P<0.001)。重症/危及生命组的凝血参数、高敏 C 反应蛋白(hsCRP)水平和降钙素原水平均高于轻症/中度组(均 P<0.05)。单因素和多因素逻辑模型显示,hsCRP 和纤维蛋白原降解产物(FDP)是重症 COVID-19 的预测指标(OR=1.072,P=0.036;OR=1.831,P=0.036)。hsCRP 和 FDP 预测重症/危及生命 COVID-19 的 AUROC 分别为 0.850 和 0.766。hsCRP 和 FDP 预测重症/危及生命 COVID-19 的最佳截断值分别为 22.41mg/L 和 0.95μg/ml。血清 CRP 和 FDP 水平与 COVID-19 的严重程度呈正相关。这一发现表明 CRP 和 FDP 水平可能作为重症的早期预测指标,有助于医生在短时间内对大量患者进行分诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aa0/7847620/14efb918a5fb/ijmsv18p1207g001.jpg

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