沙特阿拉伯宰赫兰地区感染新冠病毒个体的凝血障碍与炎症生物标志物和疾病严重程度的关联
Association of Coagulopathy and Inflammatory Biomarkers with Severity in SARS-CoV-2-Infected Individuals of the Al-Qunfudhah Region of Saudi Arabia.
作者信息
Izhari Mohammad Asrar, Hadadi Mansoor A A, Alharbi Raed A, Gosady Ahmed R A, Sindi Abdulmajeed Abdulghani A, Dardari Daifallah M M, Alotaibi Foton E, Klufah Faisal, Albanghali Mohammad A, Alharbi Tahani H
机构信息
Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha 65528, Saudi Arabia.
Laboratory Department, Qunfudhah Hospital, Al-Qunfudhah 28887, Saudi Arabia.
出版信息
Healthcare (Basel). 2024 Mar 27;12(7):729. doi: 10.3390/healthcare12070729.
BACKGROUND
Identifying prognosticators/predictors of COVID-19 severity is the principal focus for early prediction and effective management of the disease in a time-bound and cost-effective manner. We aimed to evaluate COVID-19 severity-dependent alteration in inflammatory and coagulopathy biomarkers.
METHODS
A hospital-dependent retrospective observational study (total: n = 377; male, n = 213; and female, n = 164 participants) was undertaken. COVID-19 exposure was assessed by performing real-time PCR on nasopharyngeal (NP) swabs. Descriptive and inferential statistics were applied for both continuous and categorical variables using Rstudio-version-4.0.2. Pearson correlation and regression were executed with a cut-off of < 0.05 for evaluating significance. Data representation by R-packages and ggplot2.
RESULTS
A significant variation in the mean ± SD (highly-sever (HS)/moderately severe (MS)) of CRP (HS/MS: 102.4 ± 22.9/21.3 ± 6.9, -value < 0.001), D-dimer (HS/MS: 661.1 ± 80.6/348.7 ± 42.9, -value < 0.001), and ferritin (HS/MS: 875.8 ± 126.8/593.4 ± 67.3, -value < 0.001) were observed. Thrombocytopenia, high PT, and PTT exhibited an association with the HS individuals ( < 0.001). CRP was correlated with neutrophil (r = 0.77), ferritin (r = 0.74), and WBC (r = 0.8). D-dimer correlated with platelets (r = -0.82), PT (r = 0.22), and PTT (r = 0.37). The adjusted odds ratios (Ad-OR) of CRP, ferritin, D-dimer, platelet, PT, and PTT for HS compared to MS were 1.30 (95% CI -1.137, 1.50; < 0.001), 1.048 (95% CI -1.03, 1.066; < 0.001), 1.3 (95% CI -1.24, 1.49, > 0.05), -0.813 (95% CI -0.734, 0.899, < 0.001), 1.347 (95% CI -1.15, 1.57, < 0.001), and 1.234 (95% CI -1.16, 1.314, < 0.001), respectively.
CONCLUSION
SARS-CoV-2 caused alterations in vital laboratory parameters and raised ferritin, CRP, and D-dimer presented an association with disease severity at a significant level.
背景
确定新冠病毒疾病（COVID-19）严重程度的预后因素/预测指标是对该疾病进行早期预测并以有时限且具成本效益的方式进行有效管理的主要关注点。我们旨在评估炎症和凝血病生物标志物中与COVID-19严重程度相关的变化。
方法
开展了一项基于医院的回顾性观察性研究（总计：n = 377；男性，n = 213；女性，n = 164名参与者）。通过对鼻咽拭子进行实时聚合酶链反应（PCR）来评估COVID-19暴露情况。使用Rstudio版本4.0.2对连续变量和分类变量进行描述性和推断性统计分析。执行Pearson相关性分析和回归分析，以<0.05为显著性评估临界值。通过R包和ggplot2进行数据呈现。
结果
观察到C反应蛋白（CRP）（高度严重（HS）/中度严重（MS）：102.4±22.9/21.3±6.9，p值<0.001）、D-二聚体（HS/MS：661.1±80.6/348.7±42.9，p值<0.001）和铁蛋白（HS/MS：875.8±126.8/593.4±67.3，p值<0.001）的均值±标准差存在显著差异。血小板减少、高凝血酶原时间（PT）和活化部分凝血活酶时间（PTT）与高度严重组个体相关（p<0.001）。CRP与中性粒细胞（r = 0.77）、铁蛋白（r = 0.74）和白细胞（r = 0.8）相关。D-二聚体与血小板（r = -0.82）、PT（r = 0.22）和PTT（r = 0.37）相关。与中度严重组相比，高度严重组的CRP、铁蛋白、D-二聚体、血小板、PT和PTT的调整优势比（Ad-OR）分别为1.30（95%置信区间 -1.137，1.50；p<0.001）、1.048（95%置信区间 -1.03，1.066；p<0.001）、1.3（95%置信区间 -1.24，1.49，p>0.05）、-0.813（95%置信区间 -0.734，0.899，p<0.001）、1.347（95%置信区间 -1.15，1.57，p<0.001）和1.234（95%置信区间 -1.16，1.314，p<0.001）。
结论
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）导致重要实验室参数发生变化，铁蛋白、CRP和D-二聚体升高与疾病严重程度显著相关。
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