血象参数能否用于预测住院COVID-19患者的预后?

S. Ermin, G. Polat, C. Kıraklı
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Age, sex, smoking history, chronic disease, hemogram parameters [i.e., leukocytes, neutrophils, monocytes, lymphocytes, hemoglobin, hematocrit, platelets, neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR)], D-dimer, ferritin, albumin, C-reactive protein, and lactate dehydrogenase were recorded. The relationship between hemogram parameters and poor prognosis was evaluated. The need for pulse-steroid therapy, transfer to the intensive care unit, and mortality indicated a poor prognosis. Results: The median age of the 156 patients enrolled in the study was 63 (24-94) years. Significant correlations were found in the univariate analysis between leukocytes, neutrophils, lymphocytes, monocytes, NLR, PLR, LMR, and poor prognosis (p=0.013, p=0.004, p=0.000, p=0.036, p=0.000, p=0.010, and p=0.025, respectively). 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引用次数: 0

摘要

导语:新型冠状病毒病2019 (COVID-19)已引起严重的大流行。因此,根据首次入院时获得的数据对患者进行评估是很重要的。在有症状入院的患者中,应识别病情严重的患者。本研究旨在探讨入院血象参数在预测COVID-19住院患者预后中的作用。材料和方法:回顾性纳入所有确诊或可能感染COVID-19的患者。记录年龄、性别、吸烟史、慢性病、血象参数[即白细胞、中性粒细胞、单核细胞、淋巴细胞、血红蛋白、红细胞比容、血小板、中性淋巴细胞比(NLR)、血小板-淋巴细胞比(PLR)、淋巴细胞-单核细胞比(LMR)]、d -二聚体、铁蛋白、白蛋白、c反应蛋白、乳酸脱氢酶。评价血象参数与不良预后的关系。需要脉冲类固醇治疗,转移到重症监护病房,死亡率表明预后不良。结果:156例入组患者的中位年龄为63(24-94)岁。单因素分析发现,白细胞、中性粒细胞、淋巴细胞、单核细胞、NLR、PLR、LMR与预后不良之间存在显著相关性(p=0.013, p=0.004, p=0.000, p=0.036, p=0.000, p=0.010, p=0.025)。在多因素分析中,白细胞、NLR和不良预后之间存在显著相关性(p=0.04和p=0.001)。新冠肺炎血象评分临界值为3分,敏感性87%,特异性62%。评分系统确定患者预后不良的风险。预后不良组中位评分为7分(5-8分),非预后不良组中位评分为2分(0-6分)(p<0.001)。结论:入院血象参数可用于预测COVID-19住院患者预后不良。在首次入院时使用covid - 19评分将指导医生做出治疗决定。
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Can Hemogram Parameters Be Used to Predict the Prognosis in Hospitalized COVID-19 Patients?
Introduction: The Coronavirus disease-2019 (COVID-19) has caused a serious pandemic. Thus, it is important to evaluate patients with data obtained at the first admission. Patients with severe disease should be recognized among patients admitted to the hospital symptomatically. This study aimed to examine the role of admission hemogram parameters in predicting prognosis in patients who were hospitalized for COVID-19. Materials and Methods: We enrolled all patients diagnosed with confirmed or probable COVID-19 retrospectively. Age, sex, smoking history, chronic disease, hemogram parameters [i.e., leukocytes, neutrophils, monocytes, lymphocytes, hemoglobin, hematocrit, platelets, neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR)], D-dimer, ferritin, albumin, C-reactive protein, and lactate dehydrogenase were recorded. The relationship between hemogram parameters and poor prognosis was evaluated. The need for pulse-steroid therapy, transfer to the intensive care unit, and mortality indicated a poor prognosis. Results: The median age of the 156 patients enrolled in the study was 63 (24-94) years. Significant correlations were found in the univariate analysis between leukocytes, neutrophils, lymphocytes, monocytes, NLR, PLR, LMR, and poor prognosis (p=0.013, p=0.004, p=0.000, p=0.036, p=0.000, p=0.010, and p=0.025, respectively). In the multivariate analysis, significant correlations were found between leukocytes, NLR, and poor prognosis (p=0.04 and p=0.001, respectively). The cut-off value of the COVID-hemogram score was three points, with 87% sensitivity and 62% specificity. The scoring system determined the risk for a poor prognosis in patients. The median score was 7 (5-8) in those with a poor prognosis and 2 (0-6) in those who did not have a poor prognosis (p<0.001). Conclusion: Admission hemogram parameters can be used to predict a poor prognosis in patients hospitalized for COVID-19. The use of the COVIDhemogram score in the first admission will guide physicians in making treatment decisions.
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0.40
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0.00%
发文量
37
审稿时长
8 weeks
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