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外周血淋巴细胞计数与 COVID-19 住院患者死亡风险的关系。

Association between peripheral lymphocyte count and the mortality risk of COVID-19 inpatients.

机构信息

Department of Respiratory Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, No. 365, East Renmin Road, Jinhua, 321000, Zhejiang Province, China.

Department of Nursing, Wuhan Fourth Hospital, PuAi Hospital of Tongji Medical College, Huazhong University of Science and Technology, No. 66, South Xuefu Road, Wuhan, 430032, Hubei Province, China.

出版信息

BMC Pulm Med. 2021 Feb 11;21(1):55. doi: 10.1186/s12890-021-01422-9.

Abstract

BACKGROUND

To explore the relationship between peripheral lymphocyte counts (PLCs) and the mortality risk of coronavirus disease 2019 (COVID-19), as well as the potential of PLC for predicting COVID-19 hospitalized patients death.

METHODS

Baseline characteristics, laboratory tests, imaging examinations, and outcomes of 134 consecutive COVID-19 hospitalized patients were collected from a tertiary hospital in Wuhan city from January 25 to February 24, 2020. Multiple regression analysis was used to analyze the relationship between the PLC at admission and mortality risk in COVID-19 patients and to establish a model for predicting death in COVID-19 hospitalized patients based on PLC.

RESULTS

After adjusting for potential confounding factors, we found a non-linear relationship and threshold saturation effect between PLC and mortality risk in COVID-19 patients (infection point of PLC: 0.95 × 10/L). Multiple regression analysis showed that when PLCs of COVID-19 patients were lower than 0.95 × 10/L, the patients had a significantly higher mortality risk as compared to COVID-19 patient with PLCs > 0.95 × 10/L (OR 7.27; 95% CI 1.10-48.25). The predictive power of PLC for death in COVID-19 patients (presented as area under the curve) was 0.78. The decision curve analysis showed that PLC had clinical utility for the prediction of death in COVID-19 inpatients.

CONCLUSIONS

PLC had a non-linear relationship with mortality risk in COVID-19 inpatients. Reduced PLCs (< 0.95 × 10/L) were associated with an increased mortality risk in COVID-19 inpatients. PLCs also had a potential predictive value for the death of COVID-19 inpatients.

摘要

背景

探讨外周血淋巴细胞计数(PLC)与 2019 年冠状病毒病(COVID-19)死亡率之间的关系,以及 PLC 预测 COVID-19 住院患者死亡的潜力。

方法

本研究于 2020 年 1 月 25 日至 2 月 24 日从武汉市一家三级医院收集了 134 例连续 COVID-19 住院患者的基线特征、实验室检查、影像学检查和结局。采用多元回归分析探讨入院时 PLC 与 COVID-19 患者死亡风险之间的关系,并基于 PLC 建立 COVID-19 住院患者死亡预测模型。

结果

在校正了潜在混杂因素后,我们发现 PLC 与 COVID-19 患者死亡率之间存在非线性关系和阈值饱和效应(PLC 感染点:0.95×10/L)。多元回归分析显示,当 COVID-19 患者的 PLC 低于 0.95×10/L 时,与 PLC>0.95×10/L 的 COVID-19 患者相比,患者的死亡率显著更高(OR 7.27;95%CI 1.10-48.25)。PLC 对 COVID-19 患者死亡的预测能力(表现为曲线下面积)为 0.78。决策曲线分析显示,PLC 对 COVID-19 住院患者死亡的预测具有临床实用性。

结论

PLC 与 COVID-19 住院患者的死亡率之间存在非线性关系。降低的 PLCs(<0.95×10/L)与 COVID-19 住院患者的死亡率增加相关。PLC 对 COVID-19 住院患者的死亡也具有潜在的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9cf/7879614/453153ecbfc4/12890_2021_1422_Fig1_HTML.jpg

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