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上海奥密克戎毒株流行期间老年重症新冠病毒感染的诊断模型

A diagnostic model for serious COVID-19 infection among older adults in Shanghai during the Omicron wave.

作者信息

Bao Suxia, Lu Guanzhu, Kang Yaoyue, Zhou Yuanyuan, Wang Yuhuan, Yan Lei, Yin Donglin, Bao Yujie, Yuan Xiaoling, Xu Jie

机构信息

Department of Infectious Disease, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Med (Lausanne). 2022 Dec 19;9:1018516. doi: 10.3389/fmed.2022.1018516. eCollection 2022.

Abstract

BACKGROUND

The Omicron variant is characterized by striking infectivity and antibody evasion. The analysis of Omicron variant BA.2 infection risk factors is limited among geriatric individuals and understanding these risk factors would promote improvement in the public health system and reduction in mortality. Therefore, our research investigated BA.2 infection risk factors for discriminating severe/critical from mild/moderate geriatric patients.

METHODS

Baseline characteristics of enrolled geriatric patients (aged over 60 years) with Omicron infections were analyzed. A logistic regression analysis was conducted to evaluate factors correlated with severe/critical patients. A receiver operating characteristic (ROC) curve was constructed for predicting variables to discriminate mild/moderate patients from severe/critical patients.

RESULTS

A total of 595 geriatric patients older than 60 years were enrolled in this study. Lymphocyte subset levels were significantly decreased, and white blood cells (WBCs) and D-dimer levels were significantly increased with disease progression from a mild/moderate state to a severe/critical state. Univariate and multivariate logistic regression analyses identified a panel of WBCs, CD4 T cell, and D-dimer values that were correlated with good diagnostic accuracy for discriminating mild/moderate patients from severe/critical patients with an area under the curve of 0.962.

CONCLUSION

Some key baseline laboratory indicators change with disease development. A panel was identified for discriminating mild/moderate patients from severe/critical patients, suggesting that the panel could serve as a potential biomarker to enable physicians to provide timely medical services in clinical practice.

摘要

背景

奥密克戎变异株具有显著的传染性和抗体逃逸特性。在老年人群中,对奥密克戎变异株BA.2感染风险因素的分析有限,了解这些风险因素将有助于改善公共卫生系统并降低死亡率。因此,我们的研究调查了BA.2感染的风险因素,以区分老年患者的轻症/中症与重症/危重症。

方法

分析纳入的感染奥密克戎的老年患者(年龄超过60岁)的基线特征。进行逻辑回归分析以评估与重症/危重症患者相关的因素。构建受试者操作特征(ROC)曲线以预测区分轻症/中症患者与重症/危重症患者的变量。

结果

本研究共纳入595名60岁以上的老年患者。随着疾病从轻症/中症状态发展到重症/危重症状态,淋巴细胞亚群水平显著降低,白细胞(WBC)和D-二聚体水平显著升高。单因素和多因素逻辑回归分析确定了一组白细胞、CD4 T细胞和D-二聚体值,这些值对区分轻症/中症患者与重症/危重症患者具有良好的诊断准确性,曲线下面积为0.962。

结论

一些关键的基线实验室指标随疾病发展而变化。确定了一组区分轻症/中症患者与重症/危重症患者的指标,这表明该指标组可作为一种潜在的生物标志物,使医生能够在临床实践中提供及时的医疗服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96f0/9806114/6305c233a4ad/fmed-09-1018516-g001.jpg

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