Texas Tech University Health Sciences Center, Lubbock, TX, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231206911. doi: 10.1177/21501319231206911.
The clinical presentations in patients with SARS-CoV-2 (COVID-19) infections range from asymptomatic upper respiratory infections to acute respiratory failure with bilateral pulmonary infiltrates requiring mechanical ventilation. Clinicians often measured inflammatory markers in hospitalized patients to characterize the severity of the infection. Multiple studies published in 2020 reported information on the frequency of elevated inflammatory markers in hospitalized patients in various categories of disease severity.
The PubMed database was searched using the terms "Inflammatory markers in COVID-19 patients" and "Clinical features of patients infected with COVID-19." Thirty-three publications were analyzed in detail to determine which inflammatory markers were increased and the frequency of these increases in various clinical classifications, including patients requiring hospitalization, patients with pneumonia, patients with severe infection, patients requiring intensive care unit admission, and patients who died.
C-reactive protein (CRP) was the most frequently elevated inflammatory marker in all categories. Ferritin, D-dimer, and erythrocyte sedimentation rate levels were also frequently elevated. In general, frequencies were higher in patients with more severe infections. For example, 24 out of 24 patients who died had an elevated CRP level.
This review provides concrete information about the frequency of various inflammatory markers in patients with COVID-19 infection who required hospitalization. It also provides us some insight into the approach clinicians took in the early phase of this pandemic in their efforts to characterize these patients and perhaps understand the disease process better. However, these results might suggest that clinicians and laboratory directors should develop protocols to optimize laboratory testing.
感染 SARS-CoV-2（COVID-19）的患者的临床表现从无症状上呼吸道感染到需要机械通气的急性呼吸衰竭伴双侧肺部浸润不等。临床医生通常在住院患者中测量炎症标志物，以确定感染的严重程度。2020 年发表的多项研究报告了不同疾病严重程度类别住院患者中升高的炎症标志物的频率信息。
使用术语“COVID-19 患者的炎症标志物”和“COVID-19 感染患者的临床特征”在 PubMed 数据库中进行搜索。详细分析了 33 篇出版物，以确定哪些炎症标志物升高以及在各种临床分类中这些标志物升高的频率，包括需要住院的患者、肺炎患者、严重感染患者、需要入住重症监护病房的患者和死亡患者。
在所有类别中，C 反应蛋白（CRP）是最常升高的炎症标志物。铁蛋白、D-二聚体和红细胞沉降率水平也经常升高。一般来说，在感染更严重的患者中频率更高。例如，24 名死亡患者中有 24 名 CRP 水平升高。
本综述提供了关于需要住院的 COVID-19 感染患者中各种炎症标志物频率的具体信息。它还使我们对临床医生在大流行早期努力描述这些患者并更好地了解疾病过程的方法有了一些了解。然而，这些结果可能表明临床医生和实验室主任应该制定协议以优化实验室检测。
