From the Department of Medical Biochemistry (Jeraiby, Iqbal), Faculty of Medicine, Jazan University, from the Department of Pulmonology (Hakamy, Albarqi, Areda); and from the Department of Laboratory Medicine (Haddad), King Fahad Central Hospital, Jazan, Kingdom of Saudi Arabia.
Saudi Med J. 2021 Nov;42(11):1165-1172. doi: 10.15537/smj.2021.42.11.20210429.
To validate C-reactive protein (CRP), red cell distribution width (RDW), and neutrophil lymphocyte ratio (NLR) for both serious outcomes and length of hospital stay (LOS) among hospitalized coronavirus disease-19 (COVID-19) patients.
Laboratory data of adult COVID-19 patients (n=74) was collected in this retrospective cohort. Logistic regression was employed for risk factor evaluation and receiver operating curve was used for comparison of these risk factors for the prediction of serious outcome. Multiple regression was applied to determine the association between routine analytes and LOS.
Higher levels of CRP (3 times), white blood cells (20%), and neutrophil counts (40%) were seen in the serious category. Odds ratio for CRP for the serious outcome was 1.052 (=0.007) and RDW for the serious outcome was 1.218 (=0.040) in unadjusted model and odds ratio for CRP for the serious outcome was 1.048 (=0.024) and for RDW 1.286 (=0.023) in adjusted model. In a multivariate regression analysis for the LOS of the unadjusted models consisting of NLR, monocyte lymphocyte ratio (MLR) and platelet lymphocyte ratio (PLR), the beta coefficients (BC) for the CRP were 0.006 (NLR), 0.005 (MLR) and 0.006 (PLR), whereas -0.029 (NLR), -0.034 (MLR) and -0.027 (PLR) were BCs for mean corpuscular hemoglobin concentration (MCHC). Additionally, in adjusted models, the BCs for MCHC were -0.044 (NLR), -0.047 (MLR) and -0.043 (PLR). However, the CRP was consistent with 0.004 (BC) in all models.
We observed that CRP is a better predictor than RDW and NLR for serious outcome among COVID-19 patients. Besides, CRP was positively, whereas MCHC was negatively associated with LOS.
验证 C 反应蛋白（CRP）、红细胞分布宽度（RDW）和中性粒细胞与淋巴细胞比值（NLR）在住院的 2019 冠状病毒病（COVID-19）患者中严重结局和住院时间（LOS）的预测价值。
本回顾性队列研究纳入了成年 COVID-19 患者（n=74）的实验室数据。采用 logistic 回归进行危险因素评估，并绘制受试者工作特征曲线比较这些危险因素对严重结局的预测价值。采用多元回归分析常规分析物与 LOS 的关系。
严重组的 CRP（3 倍）、白细胞（20%）和中性粒细胞计数（40%）水平更高。CRP 对严重结局的比值比（OR）在未调整模型中为 1.052（=0.007），RDW 为 1.218（=0.040），在调整模型中为 1.048（=0.024）和 1.286（=0.023）。在未调整模型中，NLR、单核细胞与淋巴细胞比值（MLR）和血小板与淋巴细胞比值（PLR）组成 LOS 的多变量回归分析中，CRP 的β系数（BC）分别为 0.006（NLR）、0.005（MLR）和 0.006（PLR），而 MCHC 的 BC 分别为-0.029（NLR）、-0.034（MLR）和-0.027（PLR）。此外，在调整模型中，MCHC 的 BC 分别为-0.044（NLR）、-0.047（MLR）和-0.043（PLR）。然而，CRP 在所有模型中均为 0.004（BC）。
我们发现 CRP 是 COVID-19 患者严重结局的预测指标优于 RDW 和 NLR。此外，CRP 与 LOS 呈正相关，而 MCHC 与 LOS 呈负相关。
