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评估常规实验室生物标志物在新冠肺炎患者中的作用:来自印度一家三级护理医院的视角

Evaluation of the Role of Routine Laboratory Biomarkers in COVID-19 Patients: Perspective from a Tertiary Care Hospital in India.

作者信息

Das Barnali, Bhatia Seema Y, Pal Poonam M

机构信息

Department of Biochemistry & Immunology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra India.

出版信息

Indian J Clin Biochem. 2021 Oct;36(4):473-484. doi: 10.1007/s12291-021-00978-x. Epub 2021 Apr 23.

Abstract

To evaluate the role of routine laboratory biomarkers like C Reactive Protein (CRP), Lactate Dehydrogenase (LDH), Interleukin 6 (IL6), Ferritin, Creatinine, Procalcitonin (PCT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Serum Albumin, Total Bilirubin (T Bil), High Sensitive Troponin I (hs troponin I), N Terminal-pro B-type Natriuretic Peptide (NT proBNP), Blood Urea Nitrogen (BUN) and Blood Gases in COVID 19 patients who are admitted with SARS CoV-2 positive test results by real-time reverse transcriptase polymerase chain reaction (rRT PCR) in Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, India. 100 individuals detected with COVID-19 belonging to the age group 12-83 years (median age 62 years) within the period of 1st March 2020 to 10th July 2020 were studied. The case group consisted of 72 males and 28 females. 40 healthy adults without any history or clinical evidence suggestive of COVID-19 and without any comorbidities, like diabetes, hypertension chronic lung disease, cardiac disease, cancer, and immune-compromised individuals were considered as a control group for the study. Routine laboratory findings of these 100 patients were used to evaluate the abnormalities found in COVID-19 patients. Statistical analysis was carried out on the data after determining whether the data had a normal/log-normal distribution and their significance was determined by calculating the p-value. The percentage of patients showing a decrease or increase from the normal value was calculated. Trend analysis was carried out for the 100 patients considered in the case group. Among them, 6 patients were used as representatives to show the trend in these biomarkers during the course of hospital stay. These 5 severe cases consisted of 2 adult males, 2 adult females, and 1 adolescent girl. This selection is to demonstrate the representation of COVID-19 infection in adult males and females and pediatric multisystem inflammatory syndrome associated with COVID-19 in the younger age group. One mild case (adult male) was also selected in the case study. We found a significant increase in mean values of AST, ALT, Total Billirubin, Creatinine, CRP, PCT, LDH, IL6, Ferritin, Lactate, hsTroponin I, NT Pro BNP and decrease in mean values of Albumin, SO2, and PO2 in COVID 19 cases than control. We applied Receiver Operating Curve (ROC) curve to discriminate case population more precisely than the control population. Therefore, Routine laboratory biomarkers appear to play a significant role in COVID-19 patients.

摘要

为评估常规实验室生物标志物,如C反应蛋白(CRP)、乳酸脱氢酶(LDH)、白细胞介素6(IL6)、铁蛋白、肌酐、降钙素原(PCT)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血清白蛋白、总胆红素(T Bil)、高敏肌钙蛋白I(hs肌钙蛋白I)、N末端B型脑钠肽前体(NT proBNP)、血尿素氮(BUN)和血气分析在印度孟买科基拉本·迪鲁拜·安巴尼医院及医学研究所经实时逆转录聚合酶链反应(rRT PCR)检测SARS-CoV-2呈阳性结果而入院的新冠肺炎患者中的作用。研究了2020年3月1日至2020年7月10日期间检测出新冠肺炎的100名年龄在12 - 83岁(中位年龄62岁)的个体。病例组由72名男性和28名女性组成。40名无任何新冠肺炎病史或临床证据且无任何合并症(如糖尿病、高血压、慢性肺病、心脏病、癌症以及免疫功能低下个体)的健康成年人被视为该研究的对照组。这100名患者的常规实验室检查结果用于评估新冠肺炎患者中发现的异常情况。在确定数据是否呈正态/对数正态分布后对数据进行统计分析,并通过计算p值确定其显著性。计算了显示高于或低于正常值患者中的百分比。对病例组的100名患者进行了趋势分析。其中,6名患者被用作代表以展示这些生物标志物在住院期间的变化趋势。这5例重症病例包括2名成年男性、2名成年女性和1名青少年女孩。这样的选择是为了展示新冠肺炎感染在成年男性和女性中的情况以及与新冠肺炎相关的小儿多系统炎症综合征在较年轻年龄组中的情况。病例研究中还选取了1例轻症病例(成年男性)。我们发现,新冠肺炎病例组中AST、ALT、总胆红素、肌酐、CRP、PCT、LDH、IL6、铁蛋白、乳酸、hs肌钙蛋白I、NT proBNP的平均值显著升高,而白蛋白、SO2和PO2的平均值降低。我们应用受试者工作特征曲线(ROC曲线)来比对照组更精确地区分病例群体。因此,常规实验室生物标志物在新冠肺炎患者中似乎发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90a9/8455759/bf85220d0bee/12291_2021_978_Fig1_HTML.jpg

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