Family Medicine, Ataturk University, Erzurum, Turkey
Emergency Medicine, Ataturk University, Erzurum, Turkey.
BMJ Open. 2023 Apr 17;13(4):e069493. doi: 10.1136/bmjopen-2022-069493.
COVID-19 is currently diagnosed in hospital settings. An easy and practical diagnosis of COVID-19 is needed in primary care. For this purpose, the usability of complete blood count in the diagnosis of COVID-19 was investigated.
Retrospective, cross-sectional study.
Single-centre study in a tertiary university hospital in Erzurum, Turkey.
Between March 2020 and February 2021, patients aged 18-70 years who applied to the hospital and underwent both complete blood count and reverse-transcription-PCR tests for COVID-19 were included and compared. Conditions affecting the test parameters (oncological-haematological conditions, chronic diseases, drug usage) were excluded.
The complete blood count and COVID-19 results of eligible patients identified using diagnostic codes [U07.3 (COVID-19) or Z03.8 (observation for other suspected diseases and conditions)] were investigated.
Of the 978 patients included, 39.4% (n=385) were positive for COVID-19 and 60.6% (n=593) were negative. The mean age was 41.5±14.5 years, and 53.9% (n=527) were male. COVID-19-positive patients were found to have significantly lower leucocyte, neutrophil, lymphocyte, monocyte, basophil, platelet and immature granulocyte (IG) values (p<0.001). Neutrophil/lymphocyte, neutrophil/monocyte and IG/lymphocyte ratios were also found to be significantly decreased (p<0.001). With logistic regression analysis, low lymphocyte count (OR 0.695; 95% CI 0.597 to 0.809) and low red cell distribution width-coefficient of variation (RDW-CV) (OR 0.887; 95% CI 0.818 to 0.962) were significantly associated with COVID-19 positivity. In receiver operating characteristic analysis, the cut-off values of lymphocyte and RDW-CV were 0.745 and 12.35, respectively.
Although our study was designed retrospectively and reflects regional data, it is important to determine that low lymphocyte count and RDW-CV can be used in the diagnosis of COVID-19 in primary care.
目前，COVID-19 在医院环境中进行诊断。在初级保健中需要一种简单实用的 COVID-19 诊断方法。为此，研究了全血细胞计数在 COVID-19 诊断中的可用性。
回顾性、横断面研究。
土耳其埃尔祖鲁姆一所三级大学医院的单中心研究。
2020 年 3 月至 2021 年 2 月期间，年龄在 18-70 岁之间，因 COVID-19 到医院就诊并接受全血细胞计数和逆转录-PCR 检测的患者被纳入并进行比较。排除影响检测参数的情况（肿瘤血液病情况、慢性疾病、药物使用）。
使用诊断代码（U07.3（COVID-19）或 Z03.8（观察其他疑似疾病和情况））确定符合条件的患者的全血细胞计数和 COVID-19 结果。
978 名患者中，39.4%（n=385）COVID-19 阳性，60.6%（n=593）COVID-19 阴性。平均年龄为 41.5±14.5 岁，53.9%（n=527）为男性。COVID-19 阳性患者的白细胞、中性粒细胞、淋巴细胞、单核细胞、嗜碱性粒细胞、血小板和不成熟粒细胞（IG）值明显较低（p<0.001）。中性粒细胞/淋巴细胞、中性粒细胞/单核细胞和 IG/淋巴细胞比值也明显降低（p<0.001）。通过逻辑回归分析，低淋巴细胞计数（OR 0.695；95%CI 0.597 至 0.809）和低红细胞分布宽度变异系数（RDW-CV）（OR 0.887；95%CI 0.818 至 0.962）与 COVID-19 阳性显著相关。在受试者工作特征分析中，淋巴细胞和 RDW-CV 的截断值分别为 0.745 和 12.35。
尽管我们的研究是回顾性设计，反映了区域性数据，但确定低淋巴细胞计数和 RDW-CV 可用于初级保健中的 COVID-19 诊断非常重要。
