Shahi Farhad, Safaee Nodehi Sayyed Reza, Fekrvand Saba, Fathi Fatemeh, Dabiri Mohammad Reza, Abdollahi Alireza, Hosseini Hanieh
Breast Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Hematology and Medical Oncology Ward, Cancer Research Center, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Int J Hematol Oncol Stem Cell Res. 2023 Apr 1;17(2):89-99. doi: 10.18502/ijhoscr.v17i2.12645.
Since 2019, Coronavirus has been a highly contagious disease. The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020. Variable laboratory findings are reported in COVID-19 patients, among which elevated levels of D-dimer, lactate dehydrogenase, as well as lymphopenia, have been reported to be associated with increased severity of disease symptoms requiring ventilator support, intensive care unit admission, and mortality. In the current study, inclusion criteria were: patient age above 18 years and hospitalization in the Imam Khomeini hospital with COVID-19 disease confirmed with nasopharyngeal swab polymerase chain reaction tests. Levels of white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin were measured and their correlation with the final patients' outcome was evaluated. A total of 208 patients were included in the present study. Higher neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, and D-dimer were significantly related to O dependency. Neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte and LDH were significantly related to higher rates of mortality. Higher Hb and lymphocyte count were significantly related to higher rates of survival. Hematological parameters including neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, D-dimer, Hb, and lymphocyte count were significantly related to the prognosis of patients with COVID-19 disease. This could help decide which COVID-19 patients have priority for hospitalization and intensive medical care, particularly when the pandemic disease causes limitations in healthcare service.
自2019年以来,冠状病毒一直是一种高传染性疾病。2020年3月,世界卫生组织宣布新型冠状病毒肺炎(COVID-19)疫情为大流行。COVID-19患者报告了各种实验室检查结果,其中D-二聚体、乳酸脱氢酶水平升高以及淋巴细胞减少与需要呼吸机支持、入住重症监护病房和死亡率增加的疾病症状严重程度相关。在本研究中,纳入标准为:年龄在18岁以上且因COVID-19疾病入住伊玛目霍梅尼医院,经鼻咽拭子聚合酶链反应检测确诊。测量白细胞、中性粒细胞、淋巴细胞、血红蛋白、血小板、D-二聚体、C反应蛋白、乳酸脱氢酶和铁蛋白水平,并评估它们与患者最终结局的相关性。本研究共纳入208例患者。较高的中性粒细胞与淋巴细胞比值、(白细胞计数减去淋巴细胞数)/淋巴细胞数、乳酸脱氢酶、血小板与淋巴细胞比值、铁蛋白和D-二聚体与氧依赖显著相关。中性粒细胞与淋巴细胞比值、(白细胞计数减去淋巴细胞数)/淋巴细胞数和乳酸脱氢酶与较高的死亡率显著相关。较高的血红蛋白和淋巴细胞计数与较高的生存率显著相关。包括中性粒细胞与淋巴细胞比值、(白细胞计数减去淋巴细胞数)/淋巴细胞数、乳酸脱氢酶、血小板与淋巴细胞比值、铁蛋白、D-二聚体、血红蛋白和淋巴细胞计数在内的血液学参数与COVID-19疾病患者的预后显著相关。这有助于确定哪些COVID-19患者优先住院和接受重症医疗,特别是在大流行疾病导致医疗服务受限的情况下。