Division of Paediatric Infectious Diseases, Department of Paediatrics, Selcuk University Faculty of Medicine, Konya, Turkey.
Division of Cardiology, Department of Paediatrics, Selcuk University Faculty of Medicine, Konya, Turkey.
Ir J Med Sci. 2022 Aug;191(4):1725-1733. doi: 10.1007/s11845-021-02762-5. Epub 2021 Sep 16.
The aim of this study was to evaluate hematological parameters in children with COVID-19 and determine the effects of inflammatory biomarkers on the assessment of hospitalization.
This retrospective single-center study was performed on 633 children with COVID-19 between March 2020 and January 2021. The study population was separated into two groups: inpatients (n = 83) and outpatients (n = 550). Univariate and multivariate logistic regression was applied to identify risk factors for hospitalization.
Lymphopenia (n = 228, 36%) was found mainly to be a hematological abnormality in all cases. Compared with outpatients, inpatients had significantly higher white blood cell (WBC) (p = 0.005), lymphocyte (p < 0.001), and platelet counts (p = 0.036), and significantly higher red cell distribution width (p = 0.001), C-reactive protein (CRP) (p = 0.003), procalcitonin (p = 0.001), D-dimer (p < 0.001), and lymphocyte to monocyte ratio values (p = 0.004). On the other hand, they had significantly lower values of hemoglobin (p < 0.001), neutrophil to lymphocyte ratio (p = 0.024), platelet lymphocyte ratio (p = 0.001), derivated neutrophil to lymphocyte ratio (p = 0.037), and mean platelet volume to lymphocyte ratio (p < 0.001). ROC analysis showed that WBC, CRP, and procalcitonin cutoff values were the best discriminated between inpatients and outpatients. The results for the areas under the curve of WBC, CRP, and procalcitonin used to assess patients' hospitalization were 0.595 (95% CI 0.519-0.670, p = 0.005), 0.599 (95% CI 0.527-0.672, p = 0.003), and 0.599 (95% CI 0.525-0.673, p = 0.004), respectively.
We suggest that high WBC and procalcitonin levels can be used as independent predictors of hospitalization in children with COVID-19.
本研究旨在评估 COVID-19 患儿的血液学参数，并确定炎症生物标志物对住院评估的影响。
本回顾性单中心研究纳入了 2020 年 3 月至 2021 年 1 月期间的 633 名 COVID-19 患儿。研究人群分为两组：住院患儿（n=83）和门诊患儿（n=550）。应用单因素和多因素逻辑回归分析确定住院的危险因素。
淋巴细胞减少症（n=228，36%）是所有病例中主要的血液学异常。与门诊患儿相比，住院患儿的白细胞（WBC）（p=0.005）、淋巴细胞（p<0.001）和血小板计数（p=0.036）明显升高，红细胞分布宽度（p=0.001）、C 反应蛋白（CRP）（p=0.003）、降钙素原（p=0.001）、D-二聚体（p<0.001）和淋巴细胞与单核细胞比值（p=0.004）明显升高。另一方面，血红蛋白（p<0.001）、中性粒细胞与淋巴细胞比值（p=0.024）、血小板与淋巴细胞比值（p=0.001）、衍生中性粒细胞与淋巴细胞比值（p=0.037）和平均血小板体积与淋巴细胞比值（p<0.001）明显降低。ROC 分析显示，WBC、CRP 和降钙素原的截断值可较好地区分住院和门诊患儿。WBC、CRP 和降钙素原用于评估患者住院的曲线下面积分别为 0.595（95%CI 0.519-0.670，p=0.005）、0.599（95%CI 0.527-0.672，p=0.003）和 0.599（95%CI 0.525-0.673，p=0.004）。
我们建议，高 WBC 和降钙素原水平可作为 COVID-19 患儿住院的独立预测因子。
