Institute of Tropical Medicine, University of Tübingen, Wilhelmstrasse 27, 72074, Tübingen, Germany.
Vietnamese-German Center for Medical Research, Hanoi, Vietnam.
Sci Rep. 2021 Jul 14;11(1):14471. doi: 10.1038/s41598-021-93950-x.
Early detection of severe forms of COVID-19 is absolutely essential for timely triage of patients. We longitudinally followed-up two well-characterized patient groups, hospitalized moderate to severe (n = 26), and ambulatory mild COVID-19 patients (n = 16) at home quarantine. Human D-dimer, C-reactive protein (CRP), ferritin, cardiac troponin I, interleukin-6 (IL-6) levels were measured on day 1, day 7, day 14 and day 28. All hospitalized patients were SARS-CoV-2 positive on admission, while all ambulatory patients were SARS-CoV-2 positive at recruitment. Hospitalized patients had higher D-dimer, CRP and ferritin, cardiac troponin I and IL-6 levels than ambulatory patients (p < 0.001, p < 0.001, p = 0.016, p = 0.035, p = 0.002 respectively). Hospitalized patients experienced significant decreases in CRP, ferritin and IL-6 levels from admission to recovery (p < 0.001, p = 0.025, and p = 0.001 respectively). Cardiac troponin I levels were high during the acute phase in both hospitalized and ambulatory patients, indicating a potential myocardial injury. In summary, D-dimer, CRP, ferritin, cardiac troponin I, IL-6 are predictive laboratory markers and can largely determine the clinical course of COVID-19, in particular the prognosis of critically ill COVID-19 patients.
早期检测 COVID-19 的严重形式对于及时对患者进行分类至关重要。我们对两组特征明确的患者进行了纵向随访，一组为住院的中重度 COVID-19 患者（n=26），另一组为在家隔离的轻度 COVID-19 患者（n=16）。在第 1、7、14 和 28 天测量了人类 D-二聚体、C 反应蛋白（CRP）、铁蛋白、肌钙蛋白 I、白细胞介素-6（IL-6）水平。所有住院患者入院时均为 SARS-CoV-2 阳性，而所有门诊患者在招募时均为 SARS-CoV-2 阳性。住院患者的 D-二聚体、CRP 和铁蛋白、肌钙蛋白 I 和 IL-6 水平均高于门诊患者（p<0.001，p<0.001，p=0.016，p=0.035，p=0.002 分别）。住院患者从入院到康复时 CRP、铁蛋白和 IL-6 水平显著下降（p<0.001，p=0.025 和 p=0.001 分别）。在住院和门诊患者中，肌钙蛋白 I 水平在急性期均较高，表明存在潜在的心肌损伤。总之，D-二聚体、CRP、铁蛋白、肌钙蛋白 I、IL-6 是预测性实验室标志物，可在很大程度上确定 COVID-19 的临床过程，特别是危重症 COVID-19 患者的预后。
