单核细胞减少症能否成为新冠疾病预后判断的新指标？
Can Monocytopenia Be a New Indicator in Determining Survival in Covid-19 Disease?
出版信息
Clin Lab. 2021 Oct 1;67(10). doi: 10.7754/Clin.Lab.2021.210215.
BACKGROUND
Monocytes play a central role in Covid-19 infection. Monocytopenia is especially observed in patients with severe infection. In our study, we aimed to investigate the effects of monocytopenia on survival in patients presenting with the suspicion of Covid-19.
METHODS
Patients diagnosed with Covid-19 who received inpatient or outpatient treatment in the pandemic clinic of Umraniye Training and Research Hospital between April 2020 and July 2020 were included in our retrospective cohort study. Patients were divided into two groups, severe and non-severe. Demographic data, laboratory parameters, those who were monocytopenic at presentation, those who developed monocytopenia during follow-up, and those with persistent monocytopenia were noted.
RESULTS
The study included 471 patients with a mean age of 50.4 ± 18.2 years. Sixty-seven (14.2%) patients had severe and 404 (85.8%) had non-severe disease. The minimum value of monocytes detected during the follow-up in severe patients was significantly lower (p < 0.001). As patients were grouped into those with monocytopenia at the time of admission, those with monocytopenia developing during their follow-up, and those whose monocytopenia at admission persisted, they were compared with regards to the presence or absence of severe disease. Newly developing monocytopenia and persistent monocytopenia were significant in patients with severe disease (p < 0.001, p = 0,001 respectively). Also, among non-surviving patients, there was a significant difference in survival times in the monocytopenia group (p = 0.029).
CONCLUSIONS
In our study, we found more developing and persistent monocytopenia in the severe group, and the survival time was low, especially in those with newly developing monocytopenia. The development of monocytopenia in the daily hemogram follow-up of the patients may increase the possibility of mortality, which suggests that monocytopenia may be a new marker in determining survival.
背景
单核细胞在新冠病毒感染中起着核心作用。在严重感染的患者中，尤其会观察到单核细胞减少症。在我们的研究中，我们旨在研究单核细胞减少症对新冠疑似患者的生存的影响。
方法
我们的回顾性队列研究纳入了 2020 年 4 月至 2020 年 7 月期间在乌姆拉尼耶培训和研究医院的大流行诊所接受住院或门诊治疗的新冠病毒患者。患者被分为严重和非严重两组。记录人口统计学数据、实验室参数、初诊时单核细胞减少症患者、随访期间发生单核细胞减少症患者以及持续性单核细胞减少症患者。
结果
该研究纳入了 471 名平均年龄为 50.4 ± 18.2 岁的患者。67 名（14.2%）患者患有严重疾病，404 名（85.8%）患者患有非严重疾病。严重患者在随访期间检测到的单核细胞最低值明显较低（p < 0.001）。将患者分为初诊时单核细胞减少症患者、随访期间发生单核细胞减少症患者以及初诊时单核细胞减少症持续存在的患者，比较他们是否患有严重疾病。新发单核细胞减少症和持续性单核细胞减少症与严重疾病相关（p < 0.001，p = 0.001）。此外，在非存活患者中，单核细胞减少症组的存活时间有显著差异（p = 0.029）。
结论
在我们的研究中，我们发现严重组中更多出现新发和持续性单核细胞减少症，而且存活时间较短，特别是在新发单核细胞减少症患者中。在患者的日常血象随访中发现单核细胞减少症可能会增加死亡率，这表明单核细胞减少症可能是预测生存的新标志物。
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