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