Gorgojo-Galindo Óscar, Martín-Fernández Marta, Peñarrubia-Ponce María Jesús, Álvarez Francisco Javier, Ortega-Loubon Christian, Gonzalo-Benito Hugo, Martínez-Paz Pedro, Miramontes-González José Pablo, Gómez-Sánchez Esther, Poves-Álvarez Rodrigo, Jorge-Monjas Pablo, Tamayo Eduardo, Heredia-Rodríguez María, Tamayo-Velasco Álvaro
BioCritic, Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain.
Research Unit, University Clinical Hospital, 47003 Valladolid, Spain.
J Clin Med. 2021 Nov 20;10(22):5431. doi: 10.3390/jcm10225431.
Pneumonia is the main cause of hospital admission in COVID-19 patients. We aimed to perform an extensive characterization of clinical, laboratory, and cytokine profiles in order to identify poor outcomes in COVID-19 patients.
A prospective and consecutive study involving 108 COVID-19 patients was conducted between March and April 2020 at Hospital Clínico Universitario de Valladolid (Spain). Plasma samples from each patient were collected after emergency room admission. Forty-five serum cytokines were measured in duplicate, and clinical data were analyzed using SPPS version 25.0.
A multivariate predictive model showed high hepatocyte growth factor (HGF) plasma levels as the only cytokine related to intubation or death risk at hospital admission (OR = 7.38, 95%CI-(1.28-42.4), = 0.025). There were no comorbidities included in the model except for the ABO blood group, in which the O blood group was associated with a 14-fold lower risk of a poor outcome. Other clinical variables were also included in the predictive model. The predictive model was internally validated by the receiver operating characteristic (ROC) curve with an area under the curve (AUC) of 0.94, a sensitivity of 91.7% and a specificity of 95%. The use of a bootstrapping method confirmed these results.
A simple, robust, and quick predictive model, based on the ABO blood group, four common laboratory values, and one specific cytokine (HGF), could be used in order to predict poor outcomes in COVID-19 patients.
肺炎是新冠病毒感染患者住院的主要原因。我们旨在对临床、实验室和细胞因子谱进行广泛表征，以确定新冠病毒感染患者的不良预后。
2020年3月至4月在西班牙巴利亚多利德大学临床医院对108例新冠病毒感染患者进行了一项前瞻性连续研究。每位患者在急诊室入院后采集血浆样本。对45种血清细胞因子进行双份检测，并使用SPPS 25.0版分析临床数据。
多变量预测模型显示，高肝细胞生长因子（HGF）血浆水平是与入院时插管或死亡风险相关的唯一细胞因子（OR = 7.38，95%CI -（1.28 - 42.4），P = 0.025）。除ABO血型外，模型中未纳入其他合并症，其中O血型与不良预后风险低14倍相关。预测模型中还纳入了其他临床变量。通过受试者工作特征（ROC）曲线对预测模型进行内部验证，曲线下面积（AUC）为0.94，敏感性为91.7%，特异性为95%。使用自助法证实了这些结果。
基于ABO血型、四个常见实验室值和一种特定细胞因子（HGF）的简单、稳健且快速的预测模型可用于预测新冠病毒感染患者的不良预后。
