印度尼西亚国家转诊医院中凝血特征与 D-二聚体、炎症标志物和 COVID-19 严重程度的相关性。
Coagulation profile and correlation between D-dimer, inflammatory markers, and COVID-19 severity in an Indonesian national referral hospital.
机构信息
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
出版信息
J Int Med Res. 2021 Nov;49(11):3000605211059939. doi: 10.1177/03000605211059939.
BACKGROUND
Coagulopathy and inflammation are associated with coronavirus disease 2019 (COVID-19) severity. This study assessed D-dimer concentration and its correlation with inflammatory markers and COVID-19 severity.
METHODS
This was a retrospective cross-sectional study involving 194 COVID-19 cases, with the severity of infection graded in accordance with the World Health Organization (WHO) guidelines. We measured D-dimer, C-reactive protein (CRP), and ferritin on admission and determined the cutoff values for D-dimer and CRP and evaluated the correlation between D-dimer and CRP and ferritin.
RESULTS
Median D-dimer, CRP, and ferritin concentrations were 2240 µg/L, 73.2 mg/L, and 1173.8 µg/mL, respectively. The highest median D-dimer value was seen in mild and moderate acute respiratory distress syndrome (ARDS). The highest ferritin concentration was seen in severe ARDS. There was a significant correlation between D-dimer value and CRP (r = 0.327), but no significant correlation between D-dimer and ferritin (r = 0.101). The area under the receiver operating characteristic curve (AUC) for the combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L as a marker of COVID-19 severity was 0.722 (95% confidence interval (CI): 0.615-0.781).
CONCLUSION
The combination of CRP ≥72.65 mg/L and D-dimer ≥1250 µg/L can be used as marker of COVID-19 severity, with moderate accuracy.
背景
凝血功能障碍和炎症与 2019 年冠状病毒病（COVID-19）的严重程度有关。本研究评估了 D-二聚体浓度及其与炎症标志物和 COVID-19 严重程度的相关性。
方法
这是一项回顾性的横断面研究，涉及 194 例 COVID-19 病例，感染严重程度根据世界卫生组织（WHO）指南进行分级。我们在入院时测量 D-二聚体、C 反应蛋白（CRP）和铁蛋白，并确定 D-二聚体和 CRP 的截断值，评估 D-二聚体与 CRP 和铁蛋白之间的相关性。
结果
中位数 D-二聚体、CRP 和铁蛋白浓度分别为 2240μg/L、73.2mg/L 和 1173.8μg/mL。轻度和中度急性呼吸窘迫综合征（ARDS）患者的 D-二聚体中位数最高。严重 ARDS 患者的铁蛋白浓度最高。D-二聚体值与 CRP 之间存在显著相关性（r=0.327），但与铁蛋白之间无显著相关性（r=0.101）。CRP≥72.65mg/L 和 D-二聚体≥1250μg/L 作为 COVID-19 严重程度标志物的组合的受试者工作特征曲线下面积（AUC）为 0.722（95%置信区间（CI）：0.615-0.781）。
结论
CRP≥72.65mg/L 和 D-二聚体≥1250μg/L 的组合可作为 COVID-19 严重程度的标志物，具有中等准确性。
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