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新冠病毒肺炎患者炎症标志物与疾病严重程度及预后的关联

Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients.

作者信息

Gjuzelova Aleksandra Aleksoska, Nakova Valentina Velkoska, Nanovic Zorica, Metodieva Marija, Stojkoska Aleksandra Jorganovic, Camurovski Nikola, Mitreski Vladimir, Krstevska Slagjana Simeonova

机构信息

1Institute of Lung Diseases and Tuberculosis, Skopje, RN Macedonia.

2Goce Delcev University, Stip, RN Macedonia.

出版信息

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2023 Mar 29;44(1):89-95. doi: 10.2478/prilozi-2023-0010. Print 2023 Mar 1.

Abstract

: The coronavirus pandemic was associated with a high mortality rate in the Republic of North Macedonia. Finding early markers of the disease's severity may predict outcomes and guide the treatment of the disease. The aim of our study was to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. : The study included 104 PCR-confirmed COVID-19 patients who underwent hospital treatment at the Institute of Lung Diseases and Tuberculosis in Skopje, North Macedonia, between November 2020 and May 2021. Inflammatory markers were assessed in all patients and correlated with the disease severity and outcome in terms of survival or death. : IL-6 and LDH at admission were significantly elevated in patients with a severe or critical form of the disease and among non-survivors. In addition, IL-6 showed 87.9% of sensitivity and 61.8% of specificity for distinguishing non-survivors from survivors with a cut-off value of 21.7 pg/ml in the receiver operator curve (ROC). Procalcitonin was significantly increased in non-survivors. Parallel to the increase of disease severity, the values of CRP and LDH increased significantly during hospitalization. : The results of the study indicate that a significant association exists between the highly increased levels of CRP, LDH, IL-6 and procalcitonin and the severity of the disease and mortality in COVID-19 patients. Their measurements and follow-up during the course of the disease could be used as predictors for prognosis and outcome but also as a subject for targeted therapy.

摘要

冠状病毒大流行与北马其顿共和国的高死亡率相关。找到该疾病严重程度的早期标志物可能有助于预测病情转归并指导疾病治疗。我们研究的目的是评估炎症标志物在预测住院COVID-19患者病情转归中的作用。

该研究纳入了2020年11月至2021年5月期间在北马其顿斯科普里肺病与结核病研究所接受住院治疗的104例经PCR确诊的COVID-19患者。对所有患者评估炎症标志物,并将其与疾病严重程度以及生存或死亡结局进行关联分析。

疾病严重或危重型患者以及非存活者入院时的IL-6和LDH显著升高。此外,在受试者工作特征曲线(ROC)中,以21.7 pg/ml为临界值时,IL-6区分非存活者与存活者的灵敏度为87.9%,特异度为61.8%。非存活者的降钙素原显著升高。随着疾病严重程度增加,住院期间CRP和LDH值也显著升高。

研究结果表明,COVID-19患者中CRP、LDH、IL-6和降钙素原水平的高度升高与疾病严重程度和死亡率之间存在显著关联。在疾病过程中对它们进行检测和随访可作为预后和结局的预测指标,也可作为靶向治疗的研究对象。

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