Department of Emergency Medicine, Henry Ford Wyandotte Hospital, Wyandotte, MI, USA.
Department of Emergency Medicine, Henry Ford Wyandotte Hospital, Wyandotte, MI, USA.
Am J Emerg Med. 2021 Aug;46:16-19. doi: 10.1016/j.ajem.2021.02.054. Epub 2021 Mar 2.
Symptoms of COVID-19 vary in severity and presentation. When admitting patients to the hospital, it is desirable to isolate patients with COVID-19 from those without the disease. However, reliably identifying patients with COVID-19 in the emergency department before hospital admission is often limited by the speed and availability of testing. Previous studies determined a low lymphocyte count is commonly found in patients with COVID-19. We sought to explore the sensitivity of absolute lymphocyte count in patients presenting to the emergency department requiring subsequent hospitalization who were found to have COVID-19.
A retrospective chart review was performed on 312 patients with laboratory-confirmed COVID-19 who were admitted to the hospital from the emergency department. The absolute lymphocyte count for these patients was used to calculate sensitivities at various cut-off values. The relationships between absolute lymphocyte count and variables, including age, sex, need for intubation, and mortality, were also explored.
Cut-off values for absolute lymphocyte count ranged from 1.1 K/uL to 2.0 K/uL, with sensitivities of 72% and 94%, respectively. Additionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died.
Knowing the sensitivity of absolute lymphocyte count in patients with COVID-19 may help identify patients who are unlikely to have the disease. Additionally, absolute lymphocyte count can be used as a marker of disease severity in patients with COVID-19.
COVID-19 的症状严重程度和表现形式各异。在将患者收入医院时,理想情况下应将 COVID-19 患者与未患该病的患者隔离开来。然而,在入院前,通过检测可靠地识别急诊科中患有 COVID-19 的患者通常受到检测速度和可用性的限制。先前的研究表明,COVID-19 患者的淋巴细胞计数通常较低。我们试图探索急诊需要住院的 COVID-19 患者的绝对淋巴细胞计数的敏感性。
对 312 名经实验室确诊为 COVID-19 并从急诊科收入医院的患者进行了回顾性图表审查。使用这些患者的绝对淋巴细胞计数来计算各个截断值的敏感性。还探索了绝对淋巴细胞计数与变量(包括年龄、性别、需要插管和死亡率)之间的关系。
绝对淋巴细胞计数的截断值范围为 1.1 K/uL 至 2.0 K/uL,敏感性分别为 72%和 94%。此外,男性、需要插管的患者和死亡的患者的平均绝对淋巴细胞计数较低。
了解 COVID-19 患者的绝对淋巴细胞计数的敏感性有助于识别不太可能患有该疾病的患者。此外,绝对淋巴细胞计数可用作 COVID-19 患者疾病严重程度的标志物。