新冠病毒肺炎住院患者血液学和止血参数的动态变化：对智利人群作为疾病严重程度生物标志物的潜在作用
Dynamic changes of hematological and hemostatic parameters in COVID-19 hospitalized patients: Potential role as severity biomarkers for the Chilean population.
作者信息
Letelier Pablo, Delgado Hugo, Garrido Felipe, Quiñones Francisco, San Martín Andrés, Hernández Loreto, Garcés Paola, Guzmán-Oyarzo Dina, Boguen Rodrigo, Hernandez Alfonso, Medina Gustavo, Schwerter Patricia, Guzmán Neftalí
机构信息
Universidad Católica de Temuco, Facultad de Ciencias de la Salud, Departamento de Procesos Diagnósticos y Evaluación, Precision Health Research Laboratory, Temuco, Chile.
Dr. Hernán Henríquez Aravena Hospital, Clinical Laboratory, Temuco, Chile.
出版信息
J Med Biochem. 2024 Jun 15;43(4):556-564. doi: 10.5937/jomb0-47588.
BACKGROUND
COVID-19 is still a global health issue, there is limited evidence in South America regarding laboratory biomarkers associated with severe disease. The objective of our study was to identify hematological and hemostatic changes associated with severe COVID-19.
METHODS
A total of 170 hospitalized patients with COVID19 were included in the study, defining their severity according to established criteria. Demographic, clinical, and laboratory (days 1, 3, 7, 15) data were obtained. We performed a statistical analysis, assuming significance with a value of p < 0.05. We analyzed the correlation between severity and biomarkers and established cut-off values for severe patients through ROC curves, estimating Odds Ratio associated with severe disease.
RESULTS
Day 1 was observed significant differences between moderate vs severe patients for leukocytes (WBC), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and D-dimer, establishing cut-off points for each of them. The markers we found associated to risk of severe disease were WBC (OR=3.2396; p = 0.0003), NLR (OR=5.7084; p < 0.0001), PLR (OR=4.4094; p < 0.0001), Neutrophil (OR=4.1193; p < 0.0001), D-dimer (OR=2.7827; p = 0.0124).
CONCLUSIONS
The results allow to establish basic laboratory biomarkers associated to severe disease, which could be used as prognostic markers.
背景
新型冠状病毒肺炎（COVID-19）仍是一个全球健康问题，在南美洲，关于与重症疾病相关的实验室生物标志物的证据有限。我们研究的目的是确定与重症COVID-19相关的血液学和止血变化。
方法
本研究共纳入170例COVID-19住院患者，根据既定标准确定其严重程度。获取人口统计学、临床和实验室（第1、3、7、15天）数据。我们进行了统计分析，假设p < 0.05具有统计学意义。我们分析了严重程度与生物标志物之间的相关性，并通过ROC曲线为重症患者确定临界值，估计与重症疾病相关的比值比。
结果
在第1天观察到中度与重度患者在白细胞（WBC）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和D-二聚体方面存在显著差异，并为每种指标确定了临界点。我们发现与重症疾病风险相关的标志物有WBC（OR = 3.2396；p = 0.0003）、NLR（OR = 5.7084；p < 0.0001）、PLR（OR = 4.4094；p < 0.0001）、中性粒细胞（OR = 4.1193；p < 0.0001）、D-二聚体（OR = 2.7827；p = 0.0124）。
结论
这些结果有助于确定与重症疾病相关的基本实验室生物标志物，可将其用作预后标志物。
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