高炎症指标是新冠病毒疾病维持性血液透析患者疾病严重程度的重要预测因素：一项横断面研究。
High inflammatory indices are significant predictors of disease severity in maintenance hemodialysis patients with COVID-19: A cross-sectional study.
作者信息
Feng Sujuan, Li Han, Wang Shixiang
机构信息
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
Institute of Uro-Nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
出版信息
Heliyon. 2024 Nov 8;10(22):e39980. doi: 10.1016/j.heliyon.2024.e39980. eCollection 2024 Nov 30.
BACKGROUND
The patients with kidney failure who undergo maintenance hemodialysis (MHD) at high risk of morbidity and mortality from COVID-19. Previous studies showed that inflammation plays an important role in the progression of COVID-19. This study aimed to evaluate the prognostic value of the inflammatory indices in MHD patients with COVID-19.
METHODS
We included 141 patients receive MHD in this single-center. SARS-CoV-2 infection was confirmed by a positive result in RT-PCR analysis of nasal and pharyngeal swab samples, and the demographic, clinical, and laboratory data from December 1, 2022, to January 31, 2023 were reviewed. Inflammatory indices including PLR, NLR and SII were calculated. Binary logistics regression was used to examine the association between inflammatory indices and SARS-CoV-2 infection in MHD patients. The ROC curves were used to detect the sensitivity and specificity of these inflammatory indices in prediction of SARS-CoV-2 infection status in MHD patients.
RESULTS
SARS-CoV-2 infection was detected in 76.43 % of the 141 MHD patients. Lymphocyte (LY), aspartate transaminase (AST), blood urea nitrogen (BUN), uric acid (UA), PLR, NLR and SII were significant predictors of no SARS-CoV-2 infection and symptomatic SARS-CoV-2 infection. In addition, LY, serum ferritin (SF), AST, BUN, UA, PLR and NLR were significant predictors of asymptomatic SARS-CoV-2 infection and symptomatic SARS-CoV-2 infection. The ROC curves showed the best sensitivity and specificity of PLR (66.7 % sensitivity; 68.8 % specificity) and NLR (51.9 % sensitivity; 86.3 % specificity) in predicting symptomatic SARS-CoV-2 infection.
CONCLUSION
PLR and NLR can be used as simple and inexpensive biomarkers in predicting the prognosis of COVID-19 in MHD patients.
背景
接受维持性血液透析（MHD）的肾衰竭患者因 COVID-19 而面临较高的发病和死亡风险。先前的研究表明，炎症在 COVID-19 的进展中起重要作用。本研究旨在评估炎症指标在 COVID-19 的 MHD 患者中的预后价值。
方法
我们纳入了该单中心 141 例接受 MHD 的患者。通过鼻拭子和咽拭子样本的 RT-PCR 分析阳性结果确诊 SARS-CoV-2 感染，并回顾了 2022 年 12 月 1 日至 2023 年 1 月 31 日的人口统计学、临床和实验室数据。计算包括血小板与淋巴细胞比值（PLR）、中性粒细胞与淋巴细胞比值（NLR）和全身炎症反应指数（SII）在内的炎症指标。采用二元逻辑回归分析 MHD 患者炎症指标与 SARS-CoV-2 感染之间的关联。使用受试者工作特征（ROC）曲线检测这些炎症指标预测 MHD 患者 SARS-CoV-2 感染状态的敏感性和特异性。
结果
141 例 MHD 患者中，76.43%检测出 SARS-CoV-2 感染。淋巴细胞（LY）、天冬氨酸转氨酶（AST）、血尿素氮（BUN）、尿酸（UA）、PLR、NLR 和 SII 是未感染 SARS-CoV-2 和有症状 SARS-CoV-2 感染的显著预测指标。此外，LY、血清铁蛋白（SF）、AST、BUN、UA、PLR 和 NLR 是无症状 SARS-CoV-2 感染和有症状 SARS-CoV-2 感染的显著预测指标。ROC 曲线显示，PLR（敏感性 66.7%；特异性 68.8%）和 NLR（敏感性 51.9%；特异性 86.3%）在预测有症状 SARS-CoV-2 感染方面具有最佳的敏感性和特异性。
结论
PLR 和 NLR 可作为预测 MHD 患者 COVID-19 预后的简单且廉价的生物标志物。
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