Internal Medicine Residency Training Program, Departamento de Medicina Interna, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Mexico City 14080, Mexico.
Internal Medicine Residency Training Program, Departamento de Medicina Interna, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Mexico City 14080, Mexico.
Clin Immunol. 2021 Apr;225:108682. doi: 10.1016/j.clim.2021.108682. Epub 2021 Feb 4.
COVID-19 can range from asymptomatic to life-threatening. Early identification of patients who will develop severe disease is crucial. A number of scores and indexes have been developed to predict severity. However, most rely on measurements not readily available. We evaluated hematological and biochemical markers taken on admission and determined how predictive they were of development of critical illness or death. We observed that higher values of readily available tests, including neutrophil:lymphocyte ratio; derived neutrophil index; and troponin I were associated with a higher risk of death or critical care admission (P < 0.001). We show that common hematological tests can be helpful in determining early in the course of illness which patients are likely to develop severe forms, as well as allocating resources to those patients early, while avoiding overuse of limited resources in patients with reduced risk of progression to severe disease.
COVID-19 的症状从无症状到危及生命不等。早期识别可能发展为重症的患者至关重要。已经开发出许多评分和指标来预测严重程度。然而，大多数评分和指标依赖于不易获得的测量值。我们评估了入院时的血液学和生化标志物，并确定它们对发生重症或死亡的预测能力。我们观察到，包括中性粒细胞与淋巴细胞比值、衍生中性粒细胞指数和肌钙蛋白 I 在内的更易获得的检测值较高与死亡或重症监护入院风险增加相关（P<0.001）。我们表明，常见的血液学检测可以帮助在疾病早期确定哪些患者可能发展为严重形式，并为这些患者早期分配资源，同时避免在进展为严重疾病风险降低的患者中过度使用有限的资源。
