COVID-19患者炎症标志物与疾病转归的关系

Sarah Shah, Dr savida ilyas dar Dar, DR Faridullah Shah Shah, Dr farhan aslam Aslam, Dr hareema saeed khan Khan, Dr anber saleem Saleem
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摘要

背景:冠状病毒病-2019 (COVID-19)已被列为全球大流行,也是严重或危重患者死亡率高的原因之一。这与先天免疫系统和适应性免疫系统的过度炎症以及由此产生的细胞因子风暴有关。我们的研究旨在评估COVID-19炎症标志物与疾病结局之间的关系。方法:本横断面研究在伊斯兰堡联邦政府综合医院(FGPC)进行,为期3个月。所有RT-PCR检测COVID-19或HRCT结果提示COVID的患者均纳入研究。检测c反应蛋白(CRP)、d -二聚体(D-Dimers)、乳酸脱氢酶(LDH)等炎症标志物,并计算DLC综合评分。记录需氧量(升/分钟)、双水平气道正压通气(BIPAP)或机械有创通气。结果:共纳入213例患者,其中男性119例(56%),女性94例(44%)。PCR阳性193例(90.6%),PCR阴性20例(9.4%),HRCT提示新冠肺炎。213例患者中有46例患者进行了HRCT检查,其中45例具有COVID-19的特征。D二聚体、LDH和CRP的AUROC分别为0.686(0.61 ~ 0.75)、0.688(0.61 ~ 0.75)和0.649(0.517 ~ 0.72),Spearman rho值分别为0.326、0.328和0.266,p值为0.000。结论:d -二聚体、LDH、CRP以及炎症标志物(DLC)和需氧量的综合评分与COVID-19患者的死亡率有显著相关性。关键词:COVID-19, CRP, LDH, D二聚体,DLC评分
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Relationship between Inflammatory Markers and Disease Outcome in COVID-19
Background: Coronavirus disease-2019 (COVID-19) has been labelled as a global pandemic and a cause of documented high mortality rates among severe or critical patients. This has been linked with hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. Our study aims to evaluate the relationship between inflammatory markers and disease outcomes in COVID-19. Methodology: This cross-sectional study was conducted at Federal Government Polyclinic (FGPC) Hospital, Islamabad for a period of 3 months. All the patients who had either RT-PCR for COVID-19 or HRCT findings suggestive of COVID were included in the study. The inflammatory markers like C-reactive protein (CRP), D-Dimers, and Lactate dehydrogenase (LDH) were done and a combined score DLC was calculated. The need for Oxygen (litres/min), Bilevel positive airway pressure (BIPAP), or Mechanical Invasive Ventilation was documented. Results: The study was conducted on 213 patients which included 119(56%) male patients and 94(44%) female patients. COVID-19 PCR was positive in 193(90.6%) while 20 patients (9.4%) had a negative PCR but HRCT suggestive of COVID. HRCT was done in a total of 46 patients out of the 213 patients and 45 had features suggestive of COVID-19. The AUROC was 0.686(0.61-0.75) for D dimers, 0.688(0.61-0.75) for LDH, and 0.649(0.517-0.72) for CRP respectively, and Spearman rho values of (0.326, 0.328 and 0.266) respectively with a p-value (0.000). Conclusion: D-dimer, LDH and CRP individually as well as a combined score of the inflammatory markers (DLC) and Oxygen requirement had a significant correlation with the mortality of the COVID-19 patients. Key words: COVID-19, CRP, LDH, D dimers, DLC score.
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