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实验室参数对新型冠状病毒肺炎预后的影响

The Effects of Laboratory Parameters on the Prognosis of COVID-19.

作者信息

Kesmez Can Fatma, Alay Handan, Albayrak Ayşe, Özden Kemalettin, Yilmaz Sinan, Öztürk Nurinnisa, Özkurt Zülal, Parlak Emine, Tekin Erdal, Koçak Abdullah Osman

机构信息

Department of Infectious Diseases and Clinical Microbiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Department of Public Health, Atatürk University Faculty of Medicine, Erzurum, Turkey.

出版信息

Eurasian J Med. 2022 Oct;54(3):242-247. doi: 10.5152/eurasianjmed.2022.22031.

Abstract

OBJECTIVE

While the coronavirus disease 2019 pandemic is an ongoing issue across the world, understanding the course of the disease is important for early diagnosis and treatment. We aimed, with this study, to determine the differences between laboratory parameters in different clinical pictures of coronavirus disease 2019.

MATERIALS AND METHODS

The study included 443 patients who presented to Atatürk University Medical Faculty Hospital between March 15, 2020, and June 15, 2020, and were diagnosed with coronavirus disease 2019 upon a positive Real Time Polymerase Chain Reaction (RT-PCR) result. The hospitalized patients were divided into 4 groups based on their clinical status. The roles of these markers in determining the severity of coronavirus disease 2019 were statistically evaluated.

RESULTS

A total of 443 patients with RT-PCR confirmation were included in the study. The mean age was 46.0 ± 19.1 years and 54.4% of the patients were male. According to the clinical classification, 16.3% of the cases were asymptomatic, 25.7% uncomplicated, 35.7% mild/moderate, and 22.3% severe. The first 3 most frequent symptoms were cough (21.3%), fever (17.7%), and fatigue (15.5%). Hypertension (36.1%) was the major comorbidity among the patients. During the follow-up of severe cases, 39.4% developed the need for intensive care. The overall mortality rate, on the other hand, was 4.7%. Regarding laboratory parameters, procalcitonin (PCT), serum ferritin, erythrocyte sedimentation rate, C-reactive protein, neutrophil count, D-dimer, troponin, and lactate dehydrogenase were at the highest level in the severe patient group while albumin, platelet, and lymphocyte count were found to be at the lowest level in the same group. A statistically significant difference was detected between the groups (P < .001).

CONCLUSION

The increase in C-reactive protein, PCT, erythrocyte sedimentation rate, ferritin, troponin, D-dimer, lactate dehydrogenase, and neutrophil count and the decrease in albumin, platelet, and lymphocyte count are significant in the severe patient group; it has been concluded that they can be used to determine the severity of coronavirus disease 2019.

摘要

目的

鉴于2019冠状病毒病疫情在全球范围内持续存在,了解该疾病的病程对于早期诊断和治疗至关重要。本研究旨在确定2019冠状病毒病不同临床症状下实验室参数的差异。

材料与方法

本研究纳入了2020年3月15日至2020年6月15日期间就诊于阿塔图尔克大学医学院医院且实时聚合酶链反应(RT-PCR)结果呈阳性、被诊断为2019冠状病毒病的443例患者。住院患者根据其临床状况分为4组。对这些标志物在确定2019冠状病毒病严重程度中的作用进行了统计学评估。

结果

本研究共纳入443例RT-PCR确诊患者。平均年龄为46.0±19.1岁,54.4%的患者为男性。根据临床分类,16.3%的病例无症状,25.7%为非复杂性病例,35.7%为轻度/中度病例,22.3%为重度病例。前3种最常见症状为咳嗽(21.3%)、发热(17.7%)和乏力(15.5%)。高血压(36.1%)是患者中主要的合并症。在重度病例的随访中,39.4%的患者发展为需要重症监护。另一方面,总体死亡率为4.7%。关于实验室参数,降钙素原(PCT)、血清铁蛋白、红细胞沉降率、C反应蛋白、中性粒细胞计数、D-二聚体、肌钙蛋白和乳酸脱氢酶在重度患者组中处于最高水平,而白蛋白、血小板和淋巴细胞计数在同一组中处于最低水平。各组之间检测到统计学显著差异(P<0.001)。

结论

重度患者组中C反应蛋白、PCT、红细胞沉降率、铁蛋白、肌钙蛋白、D-二聚体、乳酸脱氢酶和中性粒细胞计数升高以及白蛋白、血小板和淋巴细胞计数降低具有显著性;得出结论,它们可用于确定2019冠状病毒病的严重程度。

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