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揭示 COVID-19 中的免疫学和血液学标志物:来自临床研究的洞察。

Unveiling Immunological and Hematological Markers in COVID-19: Insights from a Clinical Study.

机构信息

Faculty of Allied Health Sciences, University Institute of Medical Laboratory Technology, The University of Lahore, Lahore, Pakistan.

Department of Microbiology, Faculty of Science & Technology, University of Central Punjab, Lahore, Pakistan.

出版信息

Viral Immunol. 2024 Oct;37(8):411-418. doi: 10.1089/vim.2024.0049. Epub 2024 Oct 2.

Abstract

The COVID-19 pandemic has affected the global health system and economies largely. Therefore, knowledge about the clinical and laboratory profiles of patients with COVID-19 would help in the management and prognosis of the disease. The immunological and hematological indices have emerged as critical determinants for the severity of the disease and the prognosis; however, association with COVID-19 is clouded. The present study is aimed to characterize the immunological and hematological profiles of patients with COVID-19 in correlation with the disease severity. The study included 1,019 polymerase chain reaction (PCR)-confirmed patients with COVID-19 who were classified into serious and nonserious groups, considering severity criteria. Clinical laboratory investigations included hematological, biochemical, and immunological parameters regarding leukocyte counts, hemoglobin levels, and inflammatory markers. Our analysis of immunological and hematological differences between serious and nonserious patients with COVID-19 indicates that serious cases reflected elevated levels of pro-inflammatory markers such as lactate dehydrogenase, C-reactive protein (CRP), D-dimer, and ferritin, representing immune system dysregulation and systemic inflammation. Furthermore, in serious cases, discrepancies had also been noticed for many hematological parameters than nonserious ones, which also contained leukocyte count and hemoglobin level. Additionally, the CRP, D-dimer, blood urea nitrogen, alanine transaminase, and albumin levels could be independent predictors of COVID-19 severity by multivariate logistic regression analysis. Cutoff values for these biomarkers were defined by receiver operating characteristic curve analysis defining optimal parameters for the risk stratification and prognostication. The current investigation provides a comprehensive understanding of immunological and hematological correlation with COVID-19 severity, refining clinical decision-making and therapeutic interventions to improve patient outcomes.

摘要

新冠疫情大流行在很大程度上影响了全球卫生系统和经济。因此,了解 COVID-19 患者的临床和实验室特征有助于疾病的管理和预后。免疫和血液学指标已成为疾病严重程度和预后的关键决定因素;然而,与 COVID-19 的关联尚不清楚。本研究旨在描述 COVID-19 患者的免疫和血液学特征,并与疾病严重程度相关联。该研究纳入了 1019 名经聚合酶链反应(PCR)确诊的 COVID-19 患者,根据严重程度标准分为严重和非严重组。临床实验室检查包括白细胞计数、血红蛋白水平和炎症标志物等血液学、生化和免疫学参数。我们分析了 COVID-19 严重和非严重患者之间的免疫和血液学差异,结果表明严重病例反映了乳酸脱氢酶、C 反应蛋白(CRP)、D-二聚体和铁蛋白等促炎标志物水平升高,表明免疫系统失调和全身炎症。此外,在严重病例中,与非严重病例相比,许多血液学参数也存在差异,其中包括白细胞计数和血红蛋白水平。此外,CRP、D-二聚体、血尿素氮、丙氨酸氨基转移酶和白蛋白水平可通过多元逻辑回归分析成为 COVID-19 严重程度的独立预测因子。通过受试者工作特征曲线分析定义这些生物标志物的临界值,为风险分层和预后定义最佳参数。本研究提供了对 COVID-19 严重程度与免疫和血液学相关性的全面了解,完善了临床决策和治疗干预,以改善患者预后。

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