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铁蛋白、血尿素氮和高胸部 CT 评分决定 COVID-19 阳性阿联酋患者入住 ICU:一项单中心回顾性研究。

Ferritin, blood urea nitrogen, and high chest CT score determines ICU admission in COVID-19 positive UAE patients: A single center retrospective study.

机构信息

Department of Oncology, University Hospital Sharjah, Sharjah, United Arab Emirates.

Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

出版信息

PLoS One. 2022 Jul 19;17(7):e0269185. doi: 10.1371/journal.pone.0269185. eCollection 2022.

Abstract

Coronavirus Disease (COVID-19) was declared a pandemic by WHO in March 2020. Since then, additional novel coronavirus variants have emerged challenging the current healthcare system worldwide. There is an increased need for hospital care, especially intensive care unit (ICU), for the patients severely affected by the disease. Most of the studies analyzed COVID-19 infected patients in the hospitals and established the positive correlation between clinical parameters such as high levels of D-dimer, C-reactive protein, and ferritin to the severity of infection. However, little is known about the course of the ICU admission. The retrospective study carried out at University Hospital Sharjah, UAE presented here reports an integrated analysis of the biochemical and radiological factors among the newly admitted COVID-19 patients to decide on their ICU admission. The descriptive statistical analysis revealed that patients with clinical presentations such as acute respiratory distress syndrome (ARDS) (p<0.0001) at the time of admission needed intensive care. The ROC plot indicated that radiological factors including high chest CT scores (>CO-RADS 4) in combination with biochemical parameters such as higher levels of blood urea nitrogen (>6.7 mg/dL;66% sensitivity and 75.8% specificity) and ferritin (>290 μg/mL, 71.4% sensitivity and 77.8% specificity) may predict ICU admission with 94.2% accuracy among COVID-19 patients. Collectively, these findings would benefit the hospitals to predict the ICU admission amongst COVID-19 infected patients.

摘要

2020 年 3 月,世界卫生组织宣布冠状病毒病(COVID-19)为大流行。自那时以来,新出现的新型冠状病毒变种对全球当前的医疗保健系统构成了挑战。严重受该疾病影响的患者对医院护理的需求增加,尤其是对重症监护病房(ICU)的需求增加。大多数研究分析了在医院感染 COVID-19 的患者,并确定了临床参数(如 D-二聚体、C 反应蛋白和铁蛋白水平升高)与感染严重程度之间的正相关关系。然而,对于 ICU 入院的病程知之甚少。这里报告的在阿拉伯联合酋长国沙迦大学医院进行的回顾性研究对新入院的 COVID-19 患者的生化和影像学因素进行了综合分析,以决定他们是否需要 ICU 入院。描述性统计分析表明,入院时出现急性呼吸窘迫综合征(ARDS)等临床症状的患者(p<0.0001)需要重症监护。ROC 图表明,影像学因素(包括胸部 CT 评分较高(>CO-RADS 4))与生化参数(如血尿素氮水平较高(>6.7 mg/dL;66%敏感性和 75.8%特异性)和铁蛋白水平较高(>290 μg/mL,71.4%敏感性和 77.8%特异性)相结合,可能预测 COVID-19 患者的 ICU 入院,准确率为 94.2%。总的来说,这些发现将使医院能够预测 COVID-19 感染患者的 ICU 入院情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/629b/9295942/62fc89488360/pone.0269185.g001.jpg

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