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新加坡某中心的 COVID-19 患者血液学特征。

Haematological profile of COVID-19 patients from a centre in Singapore.

机构信息

Department of Medicine, National University Health System, Singapore.

Department of Cardiology, National University Heart Centre Singapore, Singapore.

出版信息

Hematology. 2021 Dec;26(1):1007-1012. doi: 10.1080/16078454.2021.2005311.

Abstract

BACKGROUND

Haematological markers such as absolute lymphopenia have been associated with severe COVID-19 infection. However, in the literature to date, the cohorts described have typically included patients who were moderate to severely unwell with pneumonia and who required intensive care stay. It is uncertain if these markers apply to a population with less severe illness. We sought to describe the haematological profile of patients with mild disease with COVID-19 admitted to a single centre in Singapore.

METHODS

We examined 554 consecutive PCR positive SARS-COV-2 patients admitted to a single tertiary healthcare institution from Feb 2020 to April 2020. In all patients a full blood count was obtained within 24 h of presentation.

RESULTS

Patients with pneumonia had higher neutrophil percentages (66.5 ± 11.6 vs 55.2 ± 12.6%, < 0.001), lower absolute lymphocyte count (1.5 ± 1.1 vs 1.9 ± 2.1 x109/L, < 0.011) and absolute eosinophil count (0.2 ± 0.9 vs 0.7 ± 1.8 × 109/L, = 0.002). Platelet counts (210 ± 56 vs 230 ± 61, = 0.020) were slightly lower in the group with pneumonia. We did not demonstrate significant differences in the neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in patients with or without pneumonia. Sixty-eight patients (12.3%) had peripheral eosinophilia. This was more common in migrant workers living in dormitories.

CONCLUSION

Neutrophilia and lymphopenia were found to be markers associated with severe COVID-19 illness. We did not find that combined haematological parameters: neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio, had any association with disease severity in our cohort of patients with mild-moderate disease. Migrant workers living in dormitories had eosinophilia which may reflect concurrent chronic parasitic infection.

摘要

背景

血液学标志物,如绝对淋巴细胞减少,与严重的 COVID-19 感染有关。然而,迄今为止,文献中描述的队列通常包括病情中度至重度的肺炎患者,他们需要重症监护。目前尚不确定这些标志物是否适用于病情较轻的人群。我们试图描述在新加坡一家单一中心住院的轻度 COVID-19 患者的血液学特征。

方法

我们检查了 2020 年 2 月至 4 月期间从一家三级医疗机构入院的 554 例连续 PCR 阳性 SARS-COV-2 患者。所有患者均在入院后 24 小时内获得全血细胞计数。

结果

患有肺炎的患者中性粒细胞百分比较高(66.5 ± 11.6% vs 55.2 ± 12.6%,<0.001),绝对淋巴细胞计数较低(1.5 ± 1.1 vs 1.9 ± 2.1×109/L,<0.011),绝对嗜酸性粒细胞计数较低(0.2 ± 0.9 vs 0.7 ± 1.8×109/L,=0.002)。肺炎组血小板计数(210±56 vs 230±61,=0.020)略低。我们没有发现肺炎患者和无肺炎患者的中性粒细胞-淋巴细胞比值、单核细胞-淋巴细胞比值和血小板-淋巴细胞比值有显著差异。68 例(12.3%)患者外周血嗜酸性粒细胞增多。这种情况在住在宿舍的移民工人中更为常见。

结论

嗜中性粒细胞增多和淋巴细胞减少被发现是与严重 COVID-19 疾病相关的标志物。我们没有发现联合血液学参数:中性粒细胞-淋巴细胞比值、单核细胞-淋巴细胞比值和血小板-淋巴细胞比值与我们轻度-中度疾病患者队列的疾病严重程度有关。住在宿舍的移民工人嗜酸性粒细胞增多,可能反映出同时存在慢性寄生虫感染。

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