新冠肺炎住院患者部分生化和血液学指标动态特征及预测价值

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Biochemia Medica Pub Date : 2022-02-15 DOI:10.11613/BM.2022.010706
María José Castro-Castro, Laura García-Tejada, Ariadna Arbiol-Roca, Lourdes Sánchez-Navarro, Loreto Rapún-Mas, Isabel Cachon-Suárez, Marta Álvarez-Álvarez, Dolors Dot-Bach, Roser Güell-Miró, Anna Cortés-Bosch de Bassea, Macarena Dastis-Arias, Ana Sancho-Cerro, Noelia Díaz-Troyano, Teresa Escartín-Diez, Diego Muñoz-Provencio, Rosa Navarro-Badal
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引用次数: 5

摘要

部分住院患者的严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染在实验室检测中显示出一些重要变化。本研究的目的是确定与COVID-19相关的最差预后相关的最相关数量。材料和方法:这是一项描述性、纵向、观察性和回顾性研究,纳入了来自西班牙巴塞罗那Bellvitge大学医院(L'Hospitalet de Llobregat, Barcelona, Spain)的845名成年住院患者。对人口统计学、临床和实验室数据进行多元回归分析,比较幸存者(SURV)和非幸存者(no-SURV)。还进行了患者工作特征分析,以更好的特异性和敏感性建立预后不良的分界点。从症状出现后第1天到第28天,跟踪临床实验室测量的动态变化。结果:住院期间死亡的患者占18%。多因素回归分析显示,年龄、肾脏疾病、肌酐(CREA)、乳酸脱氢酶(LD)、c反应蛋白(CRP)和淋巴细胞(LYM)浓度与死亡风险的独立相关性最强。CREA、LD、CRP和LYM浓度的临界值分别为75.0 μmol /L、320 U/L、80.9 mg/L和0.69 × 109/L。动态轮廓的实验室发现,与器官损伤和组织破坏的后果一致。结论:加泰罗尼亚南部地区COVID-19患者的年龄、肾脏疾病、CREA、LD、CRP和LYM浓度为其预后提供了重要信息。由于LD随时间的稳定性,在最初评估时已被证明是预后不良的一个很好的指标。
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Dynamic profiles and predictive values of some biochemical and haematological quantities in COVID-19 inpatients.

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in some hospitalized patients has shown some important alterations in laboratory tests. The aim of this study was to establish the most relevant quantities associated with the worst prognosis related to COVID-19.

Materials and methods: This was a descriptive, longitudinal, observational and retrospective study, in a cohort of 845 adult inpatients from Bellvitge University Hospital (L'Hospitalet de Llobregat, Barcelona, Spain). A multivariate regression analysis was carried out in demographic, clinical and laboratory data, comparing survivors (SURV) and non-survivors (no-SURV). A receiver operating characteristic analysis was also carried out to establish the cut-off point for poor prognostic with better specificity and sensibility. Dynamic changes in clinical laboratory measurements were tracked from day 1 to day 28 after the onset of symptoms.

Results: During their hospital stay, 18% of the patients died. Age, kidney disease, creatinine (CREA), lactate-dehydrogenase (LD), C-reactive-protein (CRP) and lymphocyte (LYM) concentration showed the strongest independent associations with the risk of death in the multivariate regression analysis. Established cut-off values for poor prognosis for CREA, LD, CRP and LYM concentrations were 75.0 μmol /L, 320 U/L, 80.9 mg/L and 0.69 x109/L. Dynamic profile of laboratory findings, were in agreement with the consequences of organ damage and tissue destruction.

Conclusions: Age, kidney disease, CREA, LD, CRP and LYM concentrations in COVID-19 patients from the southern region of Catalonia provide important information for their prognosis. Measurement of LD has demonstrated to be very good indicator of poor prognosis at initial evaluation because of its stability over time.

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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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