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需要重症监护的新冠病毒肺炎患者实验室检查结果与死亡率之间的关系

The Relationship Between Laboratory Findings and Mortality in COVID-19 Patients Requiring Intensive Care.

作者信息

Bahceci Ilkay, Mercantepe Filiz, Duran Omer Faruk, Yildiz Soner, Sahin Kazim

机构信息

Department of Clinical Microbiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, TUR.

Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, TUR.

出版信息

Cureus. 2023 Jun 30;15(6):e41194. doi: 10.7759/cureus.41194. eCollection 2023 Jun.

Abstract

INTRODUCTION

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shows a wide clinical manifestation from asymptomatic infection to life-threatening respiratory failure. This study aimed to determine the relationship between the survival and demographic data, comorbidity status, and laboratory parameters of coronavirus disease 2019 (COVID-19) patients requiring intensive care.

MATERIAL AND METHODS

We retrospectively analyzed 236 patients requiring intensive care whose diagnosis was confirmed by the SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test. The patients were divided into two groups in terms of survival. Demographic data; procalcitonin and C-reactive protein (CRP) levels; leukocyte, lymphocyte, and neutrophil counts in hemogram and neutrophil-to-lymphocyte ratio (NLR) levels; and lower respiratory and blood cultures were examined, and the relationships between these parameters and survival were evaluated with hypothesis testing.

RESULTS

In the study, 156 (66.1%) males and 80 (33.9%) females, a total of 236 patients, were included. Sixty-seven (28.3%) surviving patients were determined as Group 1, and 169 (71.7%) deceased patients were determined as Group 2. A statistically significant difference was found between the groups in terms of mean age (p<0.001) and gender distribution (p=0.011). In laboratory parameters, a significant difference was observed between the groups in lymphocyte count (p=0.001), NLR (p<0.001), and procalcitonin levels (p<0.001). Although leukocyte (p=0.075), neutrophil (p=0.031), and CRP (p=0.112) levels were higher in Group 2, there was no statistical difference. Mortality was found to be higher in patients with comorbidity (p=0.012) or co-infection (p=0.002).

CONCLUSION

High levels of neutrophil count, NLR, and procalcitonin; low lymphocyte count; the presence of comorbidity; and secondary bacterial infection were found to be associated with mortality in COVID-19 patients in the intensive care unit.

摘要

引言

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)表现出从无症状感染到危及生命的呼吸衰竭的广泛临床表现。本研究旨在确定需要重症监护的2019冠状病毒病(COVID-19)患者的生存情况与人口统计学数据、合并症状态及实验室参数之间的关系。

材料与方法

我们回顾性分析了236例需要重症监护且经SARS-CoV-2逆转录聚合酶链反应(RT-PCR)检测确诊的患者。根据生存情况将患者分为两组。对人口统计学数据、降钙素原和C反应蛋白(CRP)水平、血常规中的白细胞、淋巴细胞和中性粒细胞计数以及中性粒细胞与淋巴细胞比值(NLR)水平,以及下呼吸道和血培养进行检查,并通过假设检验评估这些参数与生存之间的关系。

结果

本研究共纳入236例患者,其中男性156例(66.1%),女性80例(33.9%)。67例(28.3%)存活患者被确定为第1组,169例(71.7%)死亡患者被确定为第2组。两组在平均年龄(p<0.001)和性别分布(p=0.011)方面存在统计学显著差异。在实验室参数方面,两组在淋巴细胞计数(p=0.001)、NLR(p<0.001)和降钙素原水平(p<0.001)上存在显著差异。虽然第2组的白细胞(p=0.075)、中性粒细胞(p=0.031)和CRP(p=0.112)水平较高,但无统计学差异。发现合并症(p=0.012)或合并感染(p=0.002)的患者死亡率更高。

结论

发现中性粒细胞计数、NLR和降钙素原水平高、淋巴细胞计数低、合并症的存在以及继发细菌感染与重症监护病房中COVID-19患者的死亡率相关。

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