Department of Clinical Medicine, Fujian Medical University, Fujian, China.
Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Xiamen University, Teaching Hospital of Fujian Medical University, Fujian, China.
Aging (Albany NY). 2021 Sep 8;13(17):20896-20905. doi: 10.18632/aging.203501.
This study aimed to explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer, and CT score in evaluating the severity and prognosis of coronavirus disease 2019 (COVID-19).
Patients with laboratory-confirmed COVID-19 were retrospectively enrolled. The baseline data, laboratory findings, chest computed tomography (CT) results evaluated by CT score on admission, and clinical outcomes were collected and compared. Logistic regression was used to assess the independent relationship between the baseline level of the four indicators (NLR, LDH, D-dimer, and CT score) and the severity of COVID-19.
Among the 432 patients, 125 (28.94%) and 307 (71.06%) were placed in the severe and non-severe groups, respectively. As per the multivariate logistic regression, high levels of NLR and LDH were independent predictors of severe COVID-19 (OR=2.163; 95% CI=1.162-4.026; 0.015 for NLR>3.82; OR=2.298; 95% CI=1.327-3.979; 0.003 for LDH>246 U/L). Combined NLR>3.82 and LDH>246 U/L increased the sensitivity of diagnosis in patients with severe disease (NLR>3.82 [50.40%] vs. combined diagnosis [72.80%]; =0.0007; LDH>246 [59.2%] vs. combined diagnosis [72.80%]; 0.0001).
High levels of serum NLR and LDH have potential value in the early identification of patients with severe COVID-19. Moreover, the combination of LDH and NLR can improve the sensitivity of diagnosis.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、乳酸脱氢酶（LDH）、D-二聚体和 CT 评分在评估 2019 年冠状病毒病（COVID-19）严重程度和预后中的意义。
回顾性纳入经实验室确诊的 COVID-19 患者。收集并比较患者的基线数据、实验室检查结果、入院时 CT 评分评估的胸部 CT 结果以及临床结局。采用 logistic 回归评估四项指标（NLR、LDH、D-二聚体和 CT 评分）基线水平与 COVID-19 严重程度之间的独立关系。
在 432 例患者中，125 例（28.94%）和 307 例（71.06%）分别归入重症和非重症组。多变量 logistic 回归分析显示，高 NLR 和 LDH 水平是 COVID-19 重症的独立预测因子（OR=2.163；95%CI=1.162-4.026；NLR＞3.82 时 0.015；OR=2.298；95%CI=1.327-3.979；LDH＞246 U/L 时 0.003）。NLR＞3.82 和 LDH＞246 U/L 联合检测可提高重症患者的诊断敏感性（NLR＞3.82 时 50.40%，联合诊断时 72.80%；=0.0007；LDH＞246 U/L 时 59.2%，联合诊断时 72.80%；0.0001）。
血清 NLR 和 LDH 水平升高对 COVID-19 重症患者的早期识别具有潜在价值。此外，LDH 和 NLR 联合检测可提高诊断的敏感性。
