Department of Pathology, Alborz University of Medical Sciences, Karaj, Iran.
Chronic Diseases Research Center, Tehran University of Medical Sciences Endocrinology and Metabolism Research Institute, Tehran, Iran.
Virol J. 2021 Sep 17;18(1):189. doi: 10.1186/s12985-021-01658-1.
The importance of clinicolaboratory characteristics of COVID-19 made us report our findings in the Alborz province according to the latest National Guideline for the diagnosis and treatment of COVID-19 in outpatients and inpatients (trial five versions, 25 March 2020) of Iran by emphasizing rRT-PCR results, clinical features, comorbidities, and other laboratory findings in patients according to the severity of the disease.
In this study, 202 patients were included, primarily of whom 164 had fulfilled the inclusion criteria. This cross-sectional, two-center study that involved 164 symptomatic adults hospitalized with the diagnosis of COVID-19 between March 5 and April 5, 2020, was performed to analyze the frequency of rRT-PCR results, distribution of comorbidities, and initial clinicolaboratory data in severe and non-severe cases, comparing the compatibility of two methods for categorizing the severity of the disease.
According to our findings, 111 patients were rRT-PCR positive (67.6%), and 53 were rRT-PCR negative (32.4%), indicating no significant difference between severity groups that were not related to the date of symptoms' onset before admission. Based on the National Guideline, among vital signs and symptoms, mean oxygen saturation and frequency of nausea showed a significant difference between the two groups (P < 0.05); however, no significant difference was observed in comorbidities. In CURB-65 groups, among vital signs and comorbidities, mean oxygen saturation, diabetes, hypertension (HTN), hyperlipidemia, chronic heart disease (CHD), and asthma showed a significant difference between the two groups (P < 0.05), but no significant difference was seen in symptoms.
In this study, rRT-PCR results of hospitalized patients with COVID-19 were not related to severity categories. From initial clinical characteristics, decreased oxygen saturation appears to be a more common abnormality in severe and non-severe categories. National Guideline indices seem to be more comprehensive to categorize patients in severity groups than CURB-65, and there was compatibility just in non-severe groups of National Guideline and CURB-65 categories.
COVID-19 的临床实验室特征非常重要,因此我们根据伊朗最新的《门诊和住院患者 COVID-19 诊断和治疗国家指南》(第五版,2020 年 3 月 25 日)报告了我们在阿尔博兹省的发现,该指南强调了根据疾病严重程度对住院患者的 rRT-PCR 结果、临床特征、合并症和其他实验室发现进行报告。
本研究纳入了 202 例患者,其中 164 例符合纳入标准。这是一项横断面、两中心研究,共纳入了 2020 年 3 月 5 日至 4 月 5 日期间因 COVID-19 住院的 164 例有症状成年人,分析了 rRT-PCR 结果、合并症分布以及重症和非重症病例的初始临床实验室数据,比较了两种方法对疾病严重程度进行分类的一致性。
根据我们的研究结果,111 例患者 rRT-PCR 阳性(67.6%),53 例 rRT-PCR 阴性(32.4%),两组间严重程度与入院前症状出现日期无关,差异无统计学意义。根据国家指南,在生命体征和症状方面,两组间平均氧饱和度和恶心发生频率差异有统计学意义(P<0.05);但合并症无显著差异。在 CURB-65 组中,在生命体征和合并症方面,两组间平均氧饱和度、糖尿病、高血压(HTN)、高脂血症、慢性心脏病(CHD)和哮喘差异有统计学意义(P<0.05),但症状无显著差异。
在本研究中,住院 COVID-19 患者的 rRT-PCR 结果与严重程度类别无关。从初始临床特征来看,低氧饱和度在重症和非重症组中更为常见。与 CURB-65 相比,国家指南的指标似乎更全面,能够更准确地对患者进行严重程度分组,而在非重症组中,国家指南和 CURB-65 分类具有一致性。