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合并多种疾病的肺部疾病患者中COVID-19与COVID-19后综合征的实验室诊断准确性

Laboratory Diagnostics Accuracy for COVID-19 versus Post-COVID-19 Syndrome in Lung Disease Patients with Multimorbidity.

作者信息

Robu Popa Daniela, Melinte Oana Elena, Dobrin Mona-Elisabeta, Cernomaz Andrei Tudor, Grigorescu Cristina, Nemes Alexandra Floriana, Todea Doina Adina, Vulturar Damiana Maria, Grosu-Creangă Ionela Alina, Lunguleac Tiberiu, Trofor Antigona Carmen

机构信息

Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Clinical Hospital of Pulmonary Diseases, 400012 Iasi, Romania.

出版信息

J Pers Med. 2024 Jan 31;14(2):171. doi: 10.3390/jpm14020171.

Abstract

The laboratory tests and identification of risk factors such as comorbidities are essential in the management, treatment and prognosis of patients with chronic respiratory diseases. Performing rigorous monitoring among patients with post-COVID-19 syndrome and early identification of risk factors associated with poor prognosis are crucial in improving patient outcomes. In the present study, 182 patients diagnosed with COVID-19 and PCI during 2020-2022 were included. A clinical and epidemiological evaluation was performed for each patient. Laboratory tests at admission included complete blood count, Erythrocyte Sedimentation Rate (ESR) and biochemical tests. Receiver operating curve (ROC) and area under the curve (AUC) were calculated to compare the diagnostic performance of each parameter. Regarding comorbidities, arterial hypertension, diabetes mellitus and obesity were the most frequent ones. In the case of chronic lung diseases, asthma and Chronic Obstructive Pulmonary Disease (COPD) were the most frequent. Pleurisy was found especially in patients with PCI Variations in serum LDH values were observed, especially in severe forms of COVID-19 in 2020, with a mean value of 481.44 U/L, compared to patients with PCI, whose mean values (122 U/L) were within the biological range of reference. High neutrophil/lymphocyte ratio (NLR) values quantified in this study were especially associated with moderate and severe forms of COVID-19 and also PCI. The Spearman correlation coefficient was determined to measure the correlations between the clinical parameters of all investigated subjects. A value of < 0.05 was considered statistically significant. The statistical results indicated that serum lactate dehydrogenase (LDH), glucose and C-reactive protein (CRP) are sensitive markers with a diagnostic role in COVID-19, and lymphocyte (Ly) count, CRP, ESR and glucose were evidenced to be target markers in PCI. LDH values were observed to be statistically significant ( < 0.005) in patients with COVID-19 and obesity evaluated in 2021, while Ly count was statistically significant ( = 0.05) in patients with PCI and arterial hypertension. Regarding comorbidities, it has been observed that obesity, arterial hypertension and cardiovascular diseases represent risk factors in COVID-19/PCI, associated especially with the severe forms of the disease.

摘要

实验室检查以及对合并症等风险因素的识别,对于慢性呼吸道疾病患者的管理、治疗及预后至关重要。对新冠后综合征患者进行严格监测并早期识别与预后不良相关的风险因素,对改善患者预后至关重要。在本研究中,纳入了2020年至2022年期间诊断为新冠和持续性新冠感染(PCI)的182例患者。对每位患者进行了临床和流行病学评估。入院时的实验室检查包括全血细胞计数、红细胞沉降率(ESR)和生化检查。计算受试者工作特征曲线(ROC)和曲线下面积(AUC)以比较各参数的诊断性能。关于合并症,动脉高血压、糖尿病和肥胖最为常见。在慢性肺部疾病方面,哮喘和慢性阻塞性肺疾病(COPD)最为常见。胸膜炎尤其在持续性新冠感染患者中发现。观察到血清乳酸脱氢酶(LDH)值存在差异,特别是在2020年的重症新冠患者中,其平均值为481.44 U/L,而持续性新冠感染患者的平均值(122 U/L)在生物学参考范围内。本研究中量化的高中性粒细胞/淋巴细胞比值(NLR)尤其与中度和重度新冠以及持续性新冠感染相关。确定Spearman相关系数以测量所有研究对象临床参数之间的相关性。<0.05的值被认为具有统计学意义。统计结果表明,血清乳酸脱氢酶(LDH)、葡萄糖和C反应蛋白(CRP)是在新冠中具有诊断作用的敏感标志物,淋巴细胞(Ly)计数、CRP、ESR和葡萄糖被证明是持续性新冠感染中的目标标志物。在2021年评估的新冠和肥胖患者中,LDH值具有统计学意义(<0.005),而在持续性新冠感染和动脉高血压患者中,Ly计数具有统计学意义(=0.05)。关于合并症,观察到肥胖、动脉高血压和心血管疾病是新冠/持续性新冠感染中的风险因素,尤其与疾病的严重形式相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/602c/10890354/c17d7dc6bbc7/jpm-14-00171-g001.jpg

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