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预测 COVID-19 中的急性肺栓塞。

Predicting acute pulmonary embolism in COVID-19.

机构信息

Bursa City Hospital Pulmonary Medicine, Bursa, Turkey.

Bursa City Hospital, Palliative Care Unit, Geriatric Medicine Clinic, Bursa, Turkey.

出版信息

Medicine (Baltimore). 2023 Aug 25;102(34):e34916. doi: 10.1097/MD.0000000000034916.

Abstract

Acute pulmonary embolism (PE) is a life-threatening condition in patients with Coronavirus disease-2019 (COVID-19). Computed tomography pulmonary angiography is the preferred test to confirm the diagnosis. However, computed tomography pulmonary angiography is expensive and is not available in every clinic. This study aimed to determine whether clinical findings, symptoms, and parameters that are cost-effective and available in many clinics such as C-reactive protein (CRP) lymphocyte ratio (CLR), and ferritin CRP ratio (FCR) can be used in the diagnosis of PE in patients with COVID-19. Out of the reviewed files, 127 patients were diagnosed with PE, whereas 105 patients had no PE. At the first admission, laboratory parameters, complaints, respiratory rate, and percent oxygen saturation in the blood (SpO2) with a pulse oximeter were recorded for each patient. Eosinophil levels remained lower, whereas ferritin lymphocyte ratio and CLR were higher in the PE group. Patients with more elevated ferritin, CRP, and CLR had an increased mortality risk. Shortness of breath and tiredness was more common in the PE group. A decrease in eosinophil levels, whereas an increase in CLR, D-dimer, and CRP may predict PE. Elevated CLR is highly predictive of PE and is associated with increased mortality risk. COVID-19 patients with a CLR level above 81 should be investigated for PE.

摘要

急性肺栓塞(PE)是 2019 年冠状病毒病(COVID-19)患者的一种危及生命的病症。计算机断层扫描肺动脉造影是确诊的首选检查。然而,计算机断层扫描肺动脉造影费用昂贵,并非每个诊所都有。本研究旨在确定临床发现、症状以及在许多诊所都可获得的具有成本效益的参数,如 C 反应蛋白(CRP)与淋巴细胞比值(CLR)和铁蛋白 CRP 比值(FCR),是否可用于诊断 COVID-19 患者的 PE。在回顾的文件中,有 127 名患者被诊断为 PE,而 105 名患者没有 PE。在首次就诊时,为每位患者记录了实验室参数、主诉、呼吸频率以及脉搏血氧仪测量的血氧饱和度(SpO2)。PE 组的嗜酸性粒细胞水平仍然较低,而铁蛋白、淋巴细胞比值和 CLR 较高。铁蛋白、CRP 和 CLR 水平升高的患者死亡风险增加。PE 组呼吸困难和疲劳更为常见。嗜酸性粒细胞减少,而 CLR、D-二聚体和 CRP 增加可能预示着 PE。CLR 升高高度提示 PE,并与死亡风险增加相关。CLR 水平高于 81 的 COVID-19 患者应进行 PE 检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a92b/10470735/51702ba445b5/medi-102-e34916-g001.jpg

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