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炎症作为新型冠状病毒肺炎患者临床结局的预后标志

Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection.

作者信息

Fuzio Diana, Inchingolo Angelo Michele, Ruggieri Vitalba, Fasano Massimo, Federico Maria, Mandorino Manuela, Dirienzo Lavinia, Scacco Salvatore, Rizzello Alessandro, Delvecchio Maurizio, Parise Massimiliano, Rana Roberto, Faccilongo Nicola, Rapone Biagio, Inchingolo Francesco, Mancini Antonio, Fatone Maria Celeste, Gnoni Antonio, Dipalma Gianna, Dirienzo Giovanni

机构信息

Clinical Pathology Unit, Murgia Hospital, Asl Bari, 70022 Altamura, Italy.

Department of Interdisciplinary Medicine, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.

出版信息

Life (Basel). 2023 Jan 23;13(2):322. doi: 10.3390/life13020322.

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often characterized by a life-threatening interstitial pneumonia requiring hospitalization. The aim of this retrospective cohort study is to identify hallmarks of in-hospital mortality in patients affected by Coronavirus Disease 19 (COVID-19). A total of 150 patients admitted for COVID-19 from March to June 2021 to "F. Perinei" Murgia Hospital in Altamura, Italy, were divided into survivors ( = 100) and non-survivors groups ( = 50). Blood counts, inflammation-related biomarkers and lymphocyte subsets were analyzed into two groups in the first 24 h after admission and compared by Student's t-test. A multivariable logistic analysis was performed to identify independent risk factors associated with in-hospital mortality. Total lymphocyte count and CD3 and CD4 CD8 T lymphocyte subsets were significantly lower in non-survivors. Serum levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), C-reactive protein (CRP) and procalcitonin (PCT) were significantly higher in non-survivors. Age > 65 years and presence of comorbidities were identified as independent risk factors associated with in-hospital mortality, while IL-6 and LDH showed a borderline significance. According to our results, markers of inflammation and lymphocytopenia predict in-hospital mortality in COVID-19.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)通常表现为危及生命的间质性肺炎,需要住院治疗。这项回顾性队列研究的目的是确定新型冠状病毒肺炎(COVID-19)患者院内死亡的特征。2021年3月至6月期间,共有150例因COVID-19入住意大利阿尔塔穆拉“F. Perinei”穆尔贾医院的患者被分为存活组(n = 100)和非存活组(n = 50)。入院后24小时内对两组患者进行血细胞计数、炎症相关生物标志物和淋巴细胞亚群分析,并采用Student's t检验进行比较。进行多变量逻辑分析以确定与院内死亡相关的独立危险因素。非存活组的总淋巴细胞计数以及CD3和CD4/CD8 T淋巴细胞亚群显著降低。非存活组的血清白细胞介素-6(IL-6)、乳酸脱氢酶(LDH)、C反应蛋白(CRP)和降钙素原(PCT)水平显著升高。年龄>65岁和合并症被确定为与院内死亡相关的独立危险因素,而IL-6和LDH显示出临界显著性。根据我们的结果,炎症标志物和淋巴细胞减少可预测COVID-19患者的院内死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc8a/9966655/52217c60bb99/life-13-00322-g001.jpg

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