Sharafi Fateme, Jafarzadeh Esfehani Reza, Moodi Ghalibaf AmirAli, Jarahi Lida, Shamshirian Ali, Mozdourian Mahnaz
Department of Internal Medicine Mashhad University of Medical Science Mashhad Iran.
Blood Born Infections Research Center, Academic Center for Education Culture and Research (ACECR)-Khorasan Razavi Mashhad Iran.
Health Sci Rep. 2023 Sep 27;6(10):e1574. doi: 10.1002/hsr2.1574. eCollection 2023 Oct.
Predicting severe disease is important in provocative decision-making for the management of patients with the coronavirus disease 2019 (COVID-19); However, there are still some controversies about the COVID-19's severity predicting factors. This study aimed to investigate the relationships between clinical and laboratory findings regarding COVID-19's severity in patients admitted to a tertiary hospital in Mashhad, Iran.
A cross-sectional study was conducted on patients with documented COVID-19 infection based on the reverse transcription-polymerase chain reaction test. Clinical symptoms, vital signs, and medical history of the patients were recorded from their medical records. Laboratory findings and computed tomography (CT) study findings were documented. Disease severity was defined based on CT scan findings.
A total of 564 patients (58.8 ± 16.8 years old) were evaluated. The frequency of severe disease was 70.4%. There was a significant difference in heart rate ( = 0.0001), fever ( = 0.002), dyspnea ( = 0.0001), chest pain ( = 0.0001), diarrhea ( = 0.021), arthralgia ( = 0.0001), and chills ( = 0.044) as well as lymphopenia ( = 0.014), white blood cell count ( = 0.001), neutrophil count ( < 0.0001), lymphocyte count ( < 0.0001), and prothrombin time ( = 0.001) between disease severity groups. Predictors of severe COVID-19 were pulse rate (crude odds ratio [cOR] = 1.014, 95% confidence interval [CI] for cOR: 1.001, 1.027) and leukopenia (cOR = 3.910, 95% CI for cOR: 1.294, 11.809). Predictors for critical COVID-19 were pulse rate (cOR = 1.075, 95% CI for cOR: 1.046, 1.104), fever (cOR = 2.516, 95%CI for cOR: 1.020, 6.203), dyspnea (cOR = 4.190, 95% CI for cOR: 1.227, 14.306), and leukocytosis (cOR = 3.866, 95% CI for cOR: 1.815, 8.236).
Leukopenia and leukocytosis have the strongest correlation with the COVID-19 severity. These findings could be a valuable guild for clinicians in COVID-19 patient management in the inpatient setting.
在针对2019冠状病毒病（COVID-19）患者的管理进行决策时，预测重症疾病很重要；然而，关于COVID-19严重程度的预测因素仍存在一些争议。本研究旨在调查伊朗马什哈德一家三级医院收治的COVID-19患者临床及实验室检查结果与疾病严重程度之间的关系。
对基于逆转录聚合酶链反应检测确诊为COVID-19感染的患者进行横断面研究。从患者病历中记录其临床症状、生命体征和病史。记录实验室检查结果和计算机断层扫描（CT）研究结果。根据CT扫描结果定义疾病严重程度。
共评估了564例患者（年龄58.8±16.8岁）。重症疾病的发生率为70.4%。疾病严重程度组之间在心率（=0.0001）、发热（=0.002）、呼吸困难（=0.0001）、胸痛（=0.0001）、腹泻（=0.021）、关节痛（=0.0001）、寒战（=0.044）以及淋巴细胞减少（=0.014）、白细胞计数（=0.001）、中性粒细胞计数（<0.0001）、淋巴细胞计数（<0.0001）和凝血酶原时间（=0.001）方面存在显著差异。重症COVID-19的预测因素为脉搏率（粗比值比[cOR]=1.014，cOR的95%置信区间[CI]：1.001，1.027）和白细胞减少（cOR=3.910，cOR的95%CI：1.294，11.809）。危重症COVID-19的预测因素为脉搏率（cOR=1.075，cOR的95%CI：1.046，1.104）、发热（cOR=2.516，cOR的95%CI：1.020，6.203）、呼吸困难（cOR=4.190，cOR的95%CI：1.227，14.306）和白细胞增多（cOR=3.866，cOR的95%CI：1.815，8.236）。
白细胞减少和白细胞增多与COVID-严重程度的相关性最强。这些发现可为临床医生在住院环境中管理COVID-19患者提供有价值的指导。
