Department of Neurology, the Second People's Hospital of Hefei, Affiliated Hefei Hospital of Anhui Medical University, Hefei, Anhui, China.
Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People's Hospital, Anhui Mental Health Center, Hefei, Anhui, China.
Lab Med. 2021 Jul 1;52(4):e104-e114. doi: 10.1093/labmed/lmab015.
This research aims to develop a laboratory model that can accurately distinguish pneumonia from nonpneumonia in patients with COVID-19 and to identify potential protective factors against lung infection.
We recruited 50 patients diagnosed with COVID-19 infection with or without pneumonia. We selected candidate predictors through group comparison and punitive least absolute shrinkage and selection operator (LASSO) analysis. A stepwise logistic regression model was used to distinguish patients with and without pneumonia. Finally, we used a decision-tree method and randomly selected 50% of the patients 1000 times from the same specimen to verify the effectiveness of the model.
We found that the percentage of eosinophils, a high-fluorescence-reticulocyte ratio, and creatinine had better discriminatory power than other factors. Age and underlying diseases were not significant for discrimination. The model correctly discriminated 77.1% of patients. In the final validation step, we observed that the model had an overall predictive rate of 81.3%.
We developed a laboratory model for COVID-19 pneumonia in patients with mild to moderate symptoms. In the clinical setting, the model will be able to predict and differentiate pneumonia vs nonpneumonia before any lung computed tomography findings. In addition, the percentage of eosinophils, a high-fluorescence-reticulocyte ratio, and creatinine were considered protective factors against lung infection in patients without pneumonia.
本研究旨在开发一种实验室模型,能够准确区分 COVID-19 患者的肺炎与非肺炎,并识别潜在的肺部感染保护因素。
我们招募了 50 名确诊为 COVID-19 感染伴有或不伴有肺炎的患者。通过组间比较和惩罚最小绝对收缩和选择算子(LASSO)分析选择候选预测因子。使用逐步逻辑回归模型来区分有无肺炎的患者。最后,我们使用决策树方法,从相同标本中随机选择 50%的患者进行 1000 次验证,以验证模型的有效性。
我们发现嗜酸性粒细胞百分比、高荧光网织红细胞比值和肌酐比其他因素具有更好的区分能力。年龄和基础疾病对区分没有显著意义。该模型正确区分了 77.1%的患者。在最终验证步骤中,我们观察到该模型的总体预测率为 81.3%。
我们为轻度至中度症状的 COVID-19 肺炎患者开发了一种实验室模型。在临床环境中,该模型将能够在任何肺部计算机断层扫描结果出现之前预测和区分肺炎与非肺炎。此外,嗜酸性粒细胞百分比、高荧光网织红细胞比值和肌酐被认为是非肺炎患者肺部感染的保护因素。