Khodadadi Shima, Khodakarim Nastaran, Kalantari Saeed, Ranjbar Davijani Mitra, Nasri Hussein, Kheiri Usef
Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Infectious Diseases, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2023 Feb 28;37:14. doi: 10.47176/mjiri.37.14. eCollection 2023.
COVID-19 has become the greatest pandemic of the century. Considering the role of some hematologic and biochemical factors and their alterations due to the activity of the immune system, the current study aimed to evaluate LDH/CRP/ESR/RDW in patients with COVID-19 and their relationship with the severity of lung involvement based on CT scan findings.
In this cross-sectional study, some biomarkers (LDH/CRP/ESR/RDW) were measured in 158 patients who were admitted to the intensive care unit (ICU) or hospitalized in the infectious diseases ward of Rasoul-e-Akram and Firoozgar hospitals or attended to the outpatient clinics. The diagnosis was confirmed by a positive RT-PCR test in all patients. The severity of lung involvement was determined by CT scan findings for comparison. Data were collected and analyzed through SPSS version 22.
Regarding the severity of lung damage according to the CT scan, 17.7% of the patients were normal, 19% had less than 25% involvement, 17% had 25% -50% involvement, 33.5% had 50% -75% involvement, and 12% had more than 75% involvement. Considering the increasing severity of lung damage based on CT scans, the levels of RDW, ESR, CRP, and LDH significantly increased in parallel. The diagnostic value of RDW (cut-off point: 12.6, Sen: 73.1% (95%CI: 65.1-79.5), Sp: 53.6% (95%CI: 45.7-61.7), ESR (cut-off point: 49, Sen: 46.9% (95%CI: 38.2-54.5)), Sp: 85.7% (95%CI: 789.-90.5)), CRP (cut-off point: 23, Sen: 62.8% (95%CI: 54.6-70.4), Sp: 77.7% (95%CI: 70.3-84.1)) and LDH (cut-off point: 550, Sen: 65.1% (95%CI: 57.2-72.5), Sp: 85.7% (95%CI: 78.9-90.5)) were significant in diagnosing the severity of lung involvement ( < 0.05).
The use of RDW, ESR, CRP, and LDH biomarkers could be effective in predicting the severity of lung damage in patients with COVID-19.
新型冠状病毒肺炎（COVID-19）已成为本世纪最大的流行病。考虑到一些血液学和生化因素的作用及其因免疫系统活动而发生的改变，本研究旨在评估COVID-19患者的乳酸脱氢酶（LDH）/C反应蛋白（CRP）/红细胞沉降率（ESR）/红细胞分布宽度（RDW），以及基于CT扫描结果它们与肺部受累严重程度的关系。
在这项横断面研究中，对158名入住重症监护病房（ICU）、在拉苏勒 - 阿克拉姆医院和菲罗兹加尔医院传染病病房住院或在门诊就诊的患者进行了一些生物标志物（LDH/CRP/ESR/RDW）的检测。所有患者均通过逆转录聚合酶链反应（RT-PCR）检测呈阳性确诊。通过CT扫描结果确定肺部受累的严重程度以进行比较。数据通过SPSS 22版收集和分析。
根据CT扫描结果，肺部损伤的严重程度方面，17.7%的患者正常，19%的患者受累小于25%，17%的患者受累为25% - 50%，33.5%的患者受累为50% - 75%，12%的患者受累超过75%。基于CT扫描结果，随着肺部损伤严重程度的增加，RDW、ESR、CRP和LDH水平显著平行升高。RDW（截断点：12.6，敏感度：73.1%（95%置信区间：65.1 - 79.5），特异度：5
