Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.
Hubei Province Key Laboratory of Molecular Imaging.
Medicine (Baltimore). 2021 Feb 26;100(8):e23996. doi: 10.1097/MD.0000000000023996.
With the surge of newly diagnosed and severe cases of coronavirus disease 2019 (COVID-19), the death toll is mounting, this study is aimed to explore the prognostic factors of severe COVID-19. This retrospective study included 122 inpatients diagnosed with COVID-19 from January 13 to February 25, 2020. Univariate and multivariate analysis were used to identity the risk factors, receiver operating characteristics curve (ROC) analysis was used for risk stratification. The baseline neutrophil-to-lymphocyte ratio (NLR) (OR = 1.171, 95%CI = 1.049-1.306, P = .005) and Lactate dehydrogenase (LDH) (OR = 1.007, 95%CI = 1.002-1.011, P = .004) were identified as the independent risk factors for severe COVID-19 conditions, and the NLR-LDH grading system was developed to perform risk stratification. The baseline C-reactive protein (CRP) (OR = 1.019, 95%CI = 1.004-1.306, P = .016) and B-type natriuretic peptide (BNP) (OR = 1.018, 95%CI = 1.004-1.035, P = .007) were identified as the independent predictors for disease progression of severe patients. Accordingly, The NLR-LDH grading system was a useful prognostic tool for the early detection of severe COVID-19. And in the severe patients, CRP and BNP seemed to be helpful for predicting the disease progression or death.
随着 2019 年冠状病毒病（COVID-19）新确诊和重症病例的激增，死亡人数不断增加，本研究旨在探讨 COVID-19 重症的预后因素。这项回顾性研究纳入了 2020 年 1 月 13 日至 2 月 25 日期间诊断为 COVID-19 的 122 例住院患者。采用单因素和多因素分析确定危险因素，采用受试者工作特征曲线（ROC）分析进行风险分层。基线中性粒细胞与淋巴细胞比值（NLR）（OR=1.171，95%CI=1.049-1.306，P=0.005）和乳酸脱氢酶（LDH）（OR=1.007，95%CI=1.002-1.011，P=0.004）被确定为 COVID-19 重症的独立危险因素，并建立了 NLR-LDH 分级系统进行风险分层。基线 C 反应蛋白（CRP）（OR=1.019，95%CI=1.004-1.306，P=0.016）和 B 型利钠肽（BNP）（OR=1.018，95%CI=1.004-1.035，P=0.007）被确定为重症患者疾病进展的独立预测因素。因此，NLR-LDH 分级系统是早期检测 COVID-19 重症的有用预后工具。在重症患者中，CRP 和 BNP 似乎有助于预测疾病进展或死亡。
