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入院时的血液学和生化参数可预测中重度 COVID-19 患者的死亡率。

Hematological and Biochemical Parameters at Admission as Predictors for Mortality in Patients with Moderate to Severe COVID-19.

机构信息

Department of Clinical Pathology of Faculty of Medicine, Universitas Islam Sultan Agung.

Faculty of Medicine, Universitas Islam Sultan Agung.

出版信息

Ethiop J Health Sci. 2023 Mar;33(2):193-202. doi: 10.4314/ejhs.v33i2.3.

DOI:10.4314/ejhs.v33i2.3
PMID:37484181
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10358375/
Abstract

BACKGROUND

Timely diagnosis and effective use of available resources are urgent to avoid the loss of time, medical, and technological resources, particularly in COVID-19 pandemic. This study aimed to identify the most dominant predicting factor for mortality in moderate-severe COVID-19 patients.

METHODS

This retrospective cohort study included a total of 253 patients diagnosed with moderate-severe COVID-19. The primary outcome measure was mortality during hospitalization. The receiver operating characteristic (ROC) curve was used to determine cut-off points. The data were categorized according to the cut-off points in ROC curve and analyzed using Chi-square and by binary logistic regression test to identify the independent predictors associated with mortality.

RESULTS

The mean number of leukocytes (/µL), neutrophils (%), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), C-reactive protein (CRP, mg/L), and D-dimer (mg/L) in the non-survived group was significantly higher than those of the survived group. Meanwhile, the mean number of platelet count/µL, absolute lymphocyte count (ALC), in the non-survived group was significantly lower than those of the survived group. CRP level predicted mortality with a cut-off point of ≥8.41 mg/L, sensitivity of 98.1%, and specificity of 72.0% (P = .000).

CONCLUSIONS

High leukocyte count, low platelet count, high NLR, high CRP level, and high D-dimer on admission predicted mortality of COVID-19 patients. In addition, CRP was found to be the most dominant predicting factor of mortality in moderate-severe COVID-19 patients.

摘要

背景

为避免浪费时间、医疗和技术资源,尤其是在 COVID-19 大流行期间,及时诊断和有效利用现有资源迫在眉睫。本研究旨在确定中重度 COVID-19 患者死亡的主要预测因素。

方法

本回顾性队列研究共纳入 253 例中重度 COVID-19 患者。主要结局指标为住院期间的死亡率。采用受试者工作特征(ROC)曲线确定截断点。根据 ROC 曲线的截断点对数据进行分类,并使用卡方检验和二元逻辑回归检验分析与死亡率相关的独立预测因素。

结果

非存活组的白细胞计数(/µL)、中性粒细胞百分比(%)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、C 反应蛋白(CRP,mg/L)和 D-二聚体(mg/L)的平均值显著高于存活组。同时,非存活组的血小板计数/µL、绝对淋巴细胞计数(ALC)的平均值显著低于存活组。CRP 水平预测死亡率的截断点为≥8.41mg/L,敏感度为 98.1%,特异度为 72.0%(P=0.000)。

结论

入院时白细胞计数高、血小板计数低、NLR 高、CRP 水平高和 D-二聚体高均预测 COVID-19 患者的死亡率。此外,CRP 是中重度 COVID-19 患者死亡的最主要预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/10358375/94811a0f3503/EJHS3302-0193Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/10358375/ab0490572084/EJHS3302-0193Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/10358375/94811a0f3503/EJHS3302-0193Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/10358375/ab0490572084/EJHS3302-0193Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85a/10358375/94811a0f3503/EJHS3302-0193Fig2.jpg

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