Alterations in hematologic, coagulation, and inflammatory markers based on fever status in hospitalized COVID-19 patients: A retrospective study

IF 17.7 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-07-26 DOI:10.4103/jfmpc.jfmpc_226_24
Bijoya Chatterjee, Nikunj Modi, Khushi Desai, Yogesh Murugan, Ami M. Trivedi
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Abstract

ABSTRACT Laboratory markers like lymphopenia, thrombocytopenia, elevated D-dimer, and C-reactive protein (CRP) predict worse outcomes in coronavirus disease 2019 (COVID-19). However, a comprehensive analysis of hematologic and coagulation parameter alterations based on fever status is lacking. This retrospective study analyzed 300 COVID-19 patients hospitalized from March to December 2020. Demographic, clinical, and laboratory data were extracted from electronic medical records. Patients were stratified into fever (n = 200) and no fever (n = 100) groups. Hematologic, coagulation, and inflammatory markers were compared between groups using appropriate statistical tests. Multivariate regression identified independent predictors of fever. Fever was associated with leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated CRP, D-dimer, procalcitonin, interleukin-6, neutrophil to lymphocyte ratio (NLR), and ferritin compared to no fever (all P < 0.05). D-dimer (r = 0.42), CRP (r = 0.52), NLR (r = 0.48), and interleukin-6 (r = 0.46) demonstrated the strongest correlation with fever (P < 0.001). High D-dimer >1000 ng/mL (adjusted odds ratio 2.7), CRP >100 mg/L (3.1), lymphopenia <1.0 × 109/L (2.8), NLR >4 (2.9), and thrombocytopenia <150 × 109/L (2.7) were significant independent predictors of fever status (P < 0.005). These parameters had moderate sensitivity (40–60%) and high specificity (74–88%) for discriminating febrile patients with AUC of 0.85. Marked alterations in hematologic, coagulation, and inflammatory markers occur in COVID-19 based on fever. Routine laboratory parameters can facilitate diagnosis and risk stratification.
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根据 COVID-19 住院患者的发热状态对血液学、凝血和炎症指标进行分析:回顾性研究
摘要 淋巴细胞减少、血小板减少、D-二聚体升高和 C 反应蛋白(CRP)等实验室指标可预测 2019 年冠状病毒病(COVID-19)的预后。然而,目前还缺乏基于发热状态的血液学和凝血参数变化的全面分析。 这项回顾性研究分析了2020年3月至12月住院的300名COVID-19患者。研究人员从电子病历中提取了人口统计学、临床和实验室数据。患者被分为发热组(n = 200)和无发热组(n = 100)。使用适当的统计检验比较各组之间的血液学、凝血和炎症指标。多变量回归确定了发热的独立预测因素。 与不发烧相比,发烧与白细胞增多、中性粒细胞增多、淋巴细胞减少、血小板减少、CRP升高、D-二聚体、降钙素原、白细胞介素-6、中性粒细胞与淋巴细胞比值(NLR)和铁蛋白升高有关(P均<0.05)。D-二聚体(r = 0.42)、CRP(r = 0.52)、NLR(r = 0.48)和白细胞介素-6(r = 0.46)与发烧的相关性最强(P < 0.001)。高 D-二聚体 >1000 ng/mL(调整赔率 2.7)、CRP >100 mg/L (3.1)、淋巴细胞减少 4 (2.9) 和血小板减少 <150 × 109/L (2.7) 是发热状态的重要独立预测因子(P < 0.005)。这些参数对发热患者的判别具有中等灵敏度(40-60%)和高度特异性(74-88%),AUC 为 0.85。 COVID-19 在发热的基础上,血液学、凝血和炎症指标发生了明显的变化。常规实验室参数有助于诊断和风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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