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急诊科 COVID-19 诊断相关参数。

Parameters associated with diagnosis of COVID-19 in emergency department.

机构信息

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.

出版信息

Immun Inflamm Dis. 2021 Sep;9(3):851-861. doi: 10.1002/iid3.440. Epub 2021 May 7.

Abstract

OBJECTIVES

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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