感染新冠病毒奥密克戎变异株儿童的临床和血液学特征：中性粒细胞与淋巴细胞比值和嗜酸性粒细胞计数联合在区分重症新冠肺炎中的作用

Clinical and hematological characteristics of children infected with the omicron variant of SARS-CoV-2: role of the combination of the neutrophil: lymphocyte ratio and eosinophil count in distinguishing severe COVID-19.

作者信息

Jin Qiaoyan, Ma Wenxian, Zhang Wei, Wang Huiyuan, Geng Yiongxiang, Geng Yan, Zhang Yang, Gao Dan, Zhou Jing, Li Lin, Gou Yaping, Zhong Bo, Li Jing, Hou Wei, Lu Shemin

机构信息

Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Department of Biochemistry and Molecular Biology, Xi'an Jiaotong University Health Science Center, Xi'an, China.

出版信息

Front Pediatr. 2024 Jun 24;12:1305639. doi: 10.3389/fped.2024.1305639. eCollection 2024.

DOI:10.3389/fped.2024.1305639

PMID:38978839

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11228319/

Abstract

PURPOSE

Investigate the clinical/hematological characteristics of children infected with the Omicron variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and identify an effective indicator to distinguish coronavirus disease 2019 (COVID-19) severity in children.

METHODS

A retrospective study was conducted through electronic medical records from pediatric patients. The demographic, clinical, and routine blood test (RBT) features of children diagnosed by real-time PCR for SARS-CoV-2 were collected.

RESULTS

Data of 261 patients were analyzed. The most common abnormality shown by RBTs was increased monocyte count (68%). Children had "mild-moderate" or "severe" forms of COVID-19. Prevalence of abnormal neutrophil count ( = 0.048), eosinophil count ( = 0.006), mean corpuscular volume ( = 0.033), mean platelet volume ( = 0.006), platelet-large cell ratio ( = 0.043), and red blood cell distribution width-standard deviation ( = 0.031) were significantly different in the two types. A combination of the neutrophil: lymphocyte ratio (NLR) and eosinophil count for diagnosing severe COVID-19 presented the largest AUC (0.688, 95% CI = 0.599-0.777; < 0.001), and the AUC increased with a decrease in age.

CONCLUSIONS

Combination of the NLR and eosinophil count might be a promising indicator for identifying severe COVID-19 in children at infection onset.

摘要

目的

研究感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变异株的儿童的临床/血液学特征，并确定一种区分儿童2019冠状病毒病（COVID-19）严重程度的有效指标。

方法

通过儿科患者的电子病历进行回顾性研究。收集经实时聚合酶链反应诊断为SARS-CoV-2感染的儿童的人口统计学、临床和常规血液检查（RBT）特征。

结果

分析了261例患者的数据。RBT显示的最常见异常是单核细胞计数增加（68%）。儿童患有“轻度-中度”或“重度”COVID-19。两种类型中，中性粒细胞计数异常（=0.048）、嗜酸性粒细胞计数异常（=0.006）、平均红细胞体积（=0.033）、平均血小板体积（=0.006）、血小板-大细胞比率（=0.043）和红细胞分布宽度标准差（=0.031）的患病率有显著差异。中性粒细胞：淋巴细胞比率（NLR）和嗜酸性粒细胞计数联合诊断重度COVID-19的曲线下面积最大（0.688，95%可信区间=0.599-0.777；<0.001），且曲线下面积随年龄降低而增加。