Department of Chemical Pathology, University of the Witwatersrand; National Health Laboratory Service, Johannesburg, South Africa.
Department of Chemical Pathology, University of Cape Town; National Health Laboratory Service, Cape Town, South Africa.
Adv Exp Med Biol. 2021;1321:183-197. doi: 10.1007/978-3-030-59261-5_16.
We conducted a retrospective analysis on data of all adults tested for SARS-CoV-2 across our laboratory network in South Africa over a 4-month period. Out of 842,197 tests, 11.7% were positive and 88.3% negative. The prevalence of HIV was 6.25 and 6.31% in the SARS-CoV-2-positive and SARS-CoV-2-negative cohort, respectively (p = 0.444). However, the prevalence of HIV-positive individuals in the critical cohort (9.15%) was higher than in the noncritical group (6.24%) (p = 0.011). Active tuberculosis infection was approximately 50% less in SARS-CoV-2-positive than in SARS-CoV-2-negative individuals. The prevalence of uncontrolled diabetes was 3.4 times higher in SARS-CoV-2-positive cases but was not higher in the critical vs. noncritical cases (p = 0.612). The neutrophil-to-lymphocyte ratio, coagulation markers, urea, and cardiac- and liver-related analytes were significantly elevated in the critical compared to noncritical cases. Platelet count and creatinine concentration did not differ significantly between the two groups. These findings do not support increased prevalence of HIV or tuberculosis in individuals with SARS-CoV-2 infection but do suggest an association of increased disease severity with HIV-positive status. Uncontrolled diabetes was positively associated with a significantly higher prevalence of SARS-CoV-2, and our investigation into analyte changes associated with SARS-CoV-2 disease severity supported previous findings of raised inflammatory markers, coagulation markers, liver- and cardiac-related analytes, and urea but not for creatinine and platelet count.
我们对南非实验室网络在 4 个月期间检测的所有成年人的 SARS-CoV-2 数据进行了回顾性分析。在 842197 次检测中，有 11.7%呈阳性，88.3%呈阴性。SARS-CoV-2 阳性和 SARS-CoV-2 阴性队列中的 HIV 患病率分别为 6.25%和 6.31%（p=0.444）。然而，危重组中 HIV 阳性个体的患病率（9.15%）高于非危重组（6.24%）（p=0.011）。SARS-CoV-2 阳性个体的活动性肺结核感染率比 SARS-CoV-2 阴性个体低约 50%。SARS-CoV-2 阳性病例中未控制的糖尿病患病率高 3.4 倍，但在危重与非危重病例中并无更高（p=0.612）。中性粒细胞与淋巴细胞比值、凝血标志物、尿素以及心脏和肝脏相关分析物在危重病例中明显高于非危重病例。血小板计数和肌酐浓度在两组之间无显著差异。这些发现不支持 SARS-CoV-2 感染个体中 HIV 或结核病的患病率增加，但确实表明与 HIV 阳性状态相关的疾病严重程度增加。未控制的糖尿病与 SARS-CoV-2 感染的患病率显著增加呈正相关，我们对与 SARS-CoV-2 疾病严重程度相关的分析物变化的调查支持先前关于炎症标志物、凝血标志物、肝脏和心脏相关分析物以及尿素升高的发现，但肌酐和血小板计数除外。
