Department of Medicine and Science of Aging, Clinic of Infectious Diseases, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Laboratory of Biostatistics, Department of Medical, Oral, and Biotechnological Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Immun Inflamm Dis. 2021 Sep;9(3):851-861. doi: 10.1002/iid3.440. Epub 2021 May 7.
We designed this study to identify laboratory and radiological parameters, which could be useful to guide the clinician, in the evaluation of a suspected case of coronavirus disease 19 (COVID-19).
This retrospective, observational, single-center-study recruited patients with a suspect of COVID-19 data were extracted from electronic medical records using a standardized data collection form.
A total of 566 patients with suspect COVID-19 infection were enrolled (280 were COVID-19+). The COVID-19 population was characterized with bilateral-pneumonia, a lower count of neutrophil, lymphocyte and monocyte, a lower neutrophil to lymphocyte-ratio (NLR). Lower of platelet count, d-dimer, troponin I, and serum calcium were in COVID-19 patients. The occurrence of COVID-19 diagnosis increased, independently of other variables, with pneumonia (odds ratio [OR]: 3.60; p < .001), neutrophil below normal range (OR: 4.15; p < .05), lactate dehydrogenase (OR: 2.09; p < .01) and sodium above normal range (OR: 2.34; p < .01). In patients with possible respiratory acute affections we found a higher neutrophil, higher monocyte, a higher NLR and a more elevation in d-dimer. In the Sepsis group showed higher level of white blood cell, C-reactive protein, d-dimer, and procalcitonin.
Our study confirms that patients with COVID-19 have typical radiological and laboratory characteristics. The parameters highlighted in the study can help identify COVID-19 patients, also highlighting which are the main differential diagnoses to be made and the parameters that facilitate the differential diagnosis.
本研究旨在确定有助于指导临床医生评估疑似 2019 冠状病毒病（COVID-19）患者的实验室和影像学参数。
这是一项回顾性、观察性、单中心研究，使用标准化数据收集表从电子病历中提取疑似 COVID-19 感染患者的数据。
共纳入 566 例疑似 COVID-19 感染患者（280 例 COVID-19+）。COVID-19 患者表现为双侧肺炎，中性粒细胞、淋巴细胞和单核细胞计数较低，中性粒细胞与淋巴细胞比值（NLR）较低。血小板计数、D-二聚体、肌钙蛋白 I 和血清钙水平较低。COVID-19 诊断的发生增加，与其他变量独立相关，与肺炎（优势比[OR]：3.60；p<0.001）、中性粒细胞低于正常范围（OR：4.15；p<0.05）、乳酸脱氢酶（OR：2.09；p<0.01）和钠高于正常范围（OR：2.34；p<0.01）有关。在可能有呼吸道急性感染的患者中，我们发现中性粒细胞较高、单核细胞较高、NLR 较高且 D-二聚体升高更明显。在脓毒症组中，白细胞、C 反应蛋白、D-二聚体和降钙素原水平较高。
本研究证实 COVID-19 患者具有典型的影像学和实验室特征。研究中强调的参数有助于识别 COVID-19 患者，还突出了需要做出的主要鉴别诊断以及有助于鉴别诊断的参数。
