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分析基于血液的生物标志物水平改变对 COVID-19 患者预后的影响。

Analysis of altered level of blood-based biomarkers in prognosis of COVID-19 patients.

机构信息

Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Kathmandu, Bagmati, Nepal.

Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Bagmati, Nepal.

出版信息

PLoS One. 2023 Aug 4;18(8):e0287117. doi: 10.1371/journal.pone.0287117. eCollection 2023.

Abstract

INTRODUCTION

Immune and inflammatory responses developed by the patients with Coronavirus Disease 2019 (COVID-19) during rapid disease progression result in an altered level of biomarkers. Therefore, this study aimed to analyze levels of blood-based biomarkers that are significantly altered in patients with COVID-19.

METHODS

A cross-sectional study was conducted among COVID-19 diagnosed patients admitted to the tertiary care hospital. Several biomarkers-biochemical, hematological, inflammatory, cardiac, and coagulatory-were analyzed and subsequently tested for statistical significance at P<0.01 by using SPSS version 17.0.

RESULTS

A total of 1,780 samples were analyzed from 1,232 COVID-19 patients (median age 45 years [IQR 33-57]; 788 [63.96%] male). The COVID-19 patients had significantly (99% Confidence Interval, P<0.01) elevated levels of glucose, urea, alanine transaminase (ALT), aspartate aminotransaminase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), ferritin, D-Dimer, and creatinine phosphokinase-MB (CPK-MB) compared to the control group. However, the levels of total protein, albumin, and platelets were significantly (P<0.01) lowered in COVID-19 patients compared to the control group. The elevated levels of glucose, urea, WBC, CRP, D-Dimer, and LDH were significantly (P<0.01) associated with in-hospital mortality in COVID-19 patients.

CONCLUSIONS

Assessing and monitoring the elevated levels of glucose, urea, ALT, AST, ALP, WBC, CRP, PCT, IL-6, ferritin, LDH, D-Dimer, and CPK-MB and the lowered levels of total protein, albumin, and platelet could provide a basis for evaluation of improved prognosis and effective treatment in patients with COVID-19.

摘要

引言

新冠肺炎(COVID-19)患者在疾病快速进展过程中产生的免疫和炎症反应导致生物标志物水平发生改变。因此,本研究旨在分析 COVID-19 患者中显著改变的血液生物标志物水平。

方法

对一家三级护理医院收治的 COVID-19 确诊患者进行横断面研究。分析了几种生物标志物(生化、血液学、炎症、心脏和凝血),并使用 SPSS 版本 17.0 在 P<0.01 时进行了统计意义检验。

结果

共分析了 1232 例 COVID-19 患者的 1780 个样本(中位数年龄 45 岁[IQR 33-57];788 例[63.96%]男性)。与对照组相比,COVID-19 患者的血糖、尿素、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、白细胞(WBC)、C 反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、铁蛋白、D-二聚体和肌酸磷酸激酶同工酶-MB(CPK-MB)水平显著升高(99%置信区间,P<0.01)。然而,与对照组相比,COVID-19 患者的总蛋白、白蛋白和血小板水平显著降低(P<0.01)。COVID-19 患者中血糖、尿素、WBC、CRP、D-二聚体和 LDH 水平升高与住院死亡率显著相关(P<0.01)。

结论

评估和监测血糖、尿素、ALT、AST、ALP、WBC、CRP、PCT、IL-6、铁蛋白、LDH、D-二聚体和 CPK-MB 水平升高以及总蛋白、白蛋白和血小板水平降低,可为评估 COVID-19 患者预后改善和有效治疗提供依据。

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