Medical Team To Hubei Province, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Infectious Disease and Hepatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Intern Emerg Med. 2021 Aug;16(5):1165-1172. doi: 10.1007/s11739-020-02560-4. Epub 2021 Feb 10.
The outbreak of coronavirus disease (COVID-19) has brought great challenges to the world. The objectives of this study were to describe the baseline characteristics and changes of biomarkers of these COVID-19 patients and identify predictive value of the above markers for patient death. Using patient death as the observational endpoints, clinical data of inpatients in a special ward for COVID-19 in Wuhan, China were retrospectively collected. Univariate and multivariate Cox regression analyses were used to evaluate prognostic value of baseline characteristics and laboratory data changes. This study included clinical data of 75 patients. Age, c-reactive protein (CRP) and interleukin-6 levels were independent predictors of patient death. Survivors were characterized as having declining neutrophil counts, D-dimer, N-terminal pronatriuretic peptide, troponin I (TnI) and c-reactive protein levels, while counts of lymphocyte gradually came back. Non-survivors were characterized with increasing white blood cell counts (WBC) and neutrophil counts. Changes of WBC, TnI and interleukin-6 were also independently associated with patient death. Older age, baseline CRP and IL-6 levels may be used as meaningful predictors to identify patients with poor prognosis. Changes of biomarkers should be closely monitored in the management of patients with COVID-19, while constantly increasing levels of WBC, TnI and interleukin-6 in the disease course also predict patient death.
冠状病毒病（COVID-19）的爆发给世界带来了巨大的挑战。本研究的目的是描述这些 COVID-19 患者的基线特征和生物标志物变化，并确定上述标志物对患者死亡的预测价值。使用患者死亡作为观察终点，回顾性收集了中国武汉一家 COVID-19 特殊病房住院患者的临床数据。采用单因素和多因素 Cox 回归分析评估基线特征和实验室数据变化的预后价值。这项研究共纳入了 75 名患者的临床数据。年龄、C 反应蛋白（CRP）和白细胞介素 6（IL-6）水平是患者死亡的独立预测因素。存活者的特点是中性粒细胞计数、D-二聚体、N 末端脑钠肽前体、肌钙蛋白 I（TnI）和 CRP 水平逐渐下降，而淋巴细胞计数逐渐恢复。非存活者的特点是白细胞计数（WBC）和中性粒细胞计数增加。WBC、TnI 和白细胞介素 6 的变化也与患者死亡独立相关。较高的年龄、基线 CRP 和 IL-6 水平可能是识别预后不良患者的有意义的预测因素。在 COVID-19 患者的管理中应密切监测生物标志物的变化，而在疾病过程中不断增加的 WBC、TnI 和白细胞介素 6 水平也预示着患者死亡。
