Ghazanfari Tooba, Salehi Mohammad Reza, Namaki Saeed, Arabkheradmand Jalil, Rostamian Abdolrahman, Rajabnia Chenary Maryam, Ghaffarpour Sara, Kaboudanian Ardestani Sussan, Edalatifard Maryam, Naghizadeh Mohammad Mehdi, Mohammadi Saeed, Mahloujirad Maryam, Izadi Alireza, Ghanaati Hossein, Beigmohammadi Mohammad Taghi, Vodjgani Mohammad, Mohammad Shirazi Bentolhoda, Mirsharif Ensie Sadat, Abdollahi Alireza, Mohammadi Mostafa, Emadi Kouchak Hamid, Dehghan Manshadi Seyed Ali, Zamani Mohammad Saber, Mahmoodi Aliabadi Maedeh, Jamali Davoud, Khajavirad Nasim, Mohseni Majd Ali Mohammad, Nasiri Zahra, Faghihzadeh Soghrat
Immunoregulation Research Center, Shahed University, Tehran, Iran AND Simorgh Clinical Laboratory, Tehran, Iran.
Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2021 Feb 11;20(1):46-66. doi: 10.18502/ijaai.v20i1.5412.
The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) spread rapidly all over the world in late 2019 and caused critical illness and death in some infected patients. This study aimed at examining several laboratory factors, especially inflammatory and immunological mediators, to identify severity and mortality associated biomarkers. Ninety-three hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) were classified based on disease severity. The levels of biochemical, hematological, immunological, and inflammatory mediators were assessed, and their association with severity and mortality were evaluated. Hospitalized patients were mostly men (77.4%) with an average (standard deviation) age of 59.14 (14.81) years. The mortality rate was significantly higher in critical patients (85.7%). Increased serum levels of blood sugar, urea, creatinine, uric acid, phosphorus, total bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, C-reactive protein, ferritin, and procalcitonin were significantly prevalent (p=0.002, p<0.001, p<0.001, p=0.014, p=0.047, p=0.003, p<0.001, p<0.001, p<0.001, p<0.001, P<0.001, and p<0.001, respectively) in COVID-19 patients. Decreased red blood cell, hemoglobin, and hematocrit were significantly prevalent among COVID-19 patients than healthy control subjects (p<0.001 for all). Troponin-I, interleukin-6, neutrophil/lymphocyte ratio (NLR), procalcitonin, and D-dimer showed a significant association with the mortality of patients with specificity and sensitivity more than 60%. Age, sex, underlying diseases, blood oxygen pressure, complete blood count along with C-reactive protein, lactic dehydrogenase, procalcitonin, D-dimer, and interleukin-6 evaluation help to predict the severity and required management for COVID-19 patients. Further investigations are highly recommended in a larger cohort study for validation of the present findings.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）于2019年末在全球迅速传播，导致部分感染患者出现重症和死亡。本研究旨在检测多项实验室指标，尤其是炎症和免疫介质，以确定与疾病严重程度和死亡率相关的生物标志物。93例确诊新型冠状病毒肺炎（COVID-19）的住院患者根据疾病严重程度进行分类。评估了生化、血液学、免疫学和炎症介质水平，并评估了它们与疾病严重程度和死亡率的关联。住院患者大多为男性（77.4%），平均（标准差）年龄为59.14（14.81）岁。重症患者的死亡率显著更高（85.7%）。COVID-19患者血清中血糖、尿素、肌酐、尿酸、磷、总胆红素、血清谷草转氨酶、血清谷丙转氨酶、乳酸脱氢酶、C反应蛋白、铁蛋白和降钙素原水平显著升高（p值分别为0.002、<0.001、<0.001、0.014、0.047、0.003、<0.001、<0.001、<0.001、<0.001、<0.001）。COVID-19患者中红细胞、血红蛋白和血细胞比容降低的情况显著多于健康对照者（所有p值均<0.001）。肌钙蛋白I、白细胞介素-6、中性粒细胞/淋巴细胞比值（NLR）、降钙素原和D-二聚体与患者死亡率显著相关，特异性和敏感性均超过60%。年龄、性别、基础疾病、血氧分压、全血细胞计数以及C反应蛋白、乳酸脱氢酶、降钙素原、D-二聚体和白细胞介素-6评估有助于预测COVID-19患者的病情严重程度和所需治疗。强烈建议在更大规模的队列研究中进行进一步调查以验证本研究结果。
