137例COVID-19患者血常规及部分生化指标与病情严重程度的相关性

doi:10.3969/j.issn.1671-7171.2022.02.005

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Abstract 【Objective】To investigate the blood routine and biochemical indexes of 139 patients with coronavirus disease COVID-19, and explore the relationship between the indexes and the severity of COVID-19 disease. 【Methods】Clinical data of 137 patients with COVID-19 were collected from the Public Health Treatment Center of Changsha during January to March of 2020. The blood routine, liver and kidney function, myocardial enzymes, inflammation index (CRP), coagulation function and other data were compared between severe (n=25) and non-severe (n=112) COVID-19 patients. Logistic regression was used to analyze the early warning index of severe COVID-19.The value of predicting the progress of LDH, CRP and LYM to heavy COVID-19 was analyzed by using receiver operating characteristic curve (ROC curve). 【Results】 Severe patients had higher levels of age, neutrophil percentage (NEU%), C-reactive protein (CRP), creatine kinase (CK) and lactate dehydrogenase (LDH) than the non-severe patients(P<0.05). Lymphocyte count(LYM)was significantly lower in the severe group than that in the non-severe group(P<0.05).There were no significant differences in sex ratio, days of treatment, white blood cell count(WBC), platelet count(PLT), creatine kinase isoenzyme(CK-MB), total bilirubin(TBIL), alanine aminotransferase(ALB), aspartate aminotransferase (AST), albumin (ALB), creatinine (CREA), blood urea nitrogen (BUN), prothrombin time (PT) between the two groups(P>0.05). The spearman rank correlation test showed that age, NEU%, LYM count, CRP, CK and LDH were all significantly correlated with the severity of COVID-19;The correlation coefficients were 0.338, 0.516, -0.324, 0.477, 0.567 and 0.292, respectively, (P<0.05). ROC curve analysis shows that the optimal threshold for LDH was 262.60 U/L, the area under the curve (AUC) was 0.924, the sensitivity was 76.0%, and the specificity was 95.5%. The optimal threshold for CRP was 34.28 mg/L, the AUC was 0.856, the sensitivity was 76.0% , and the specificity was 86.6%. The optimal threshold of LYM was 0.925×10⁹/L, the AUC was 0.742, the sensitivity was 76%, and the specificity was 63.4%. The AUC of the combined analysis of LDH, CRP and LYM was 0.944 (P<0.05), and the combined detection of the three had the highest diagnostic value.【Conclusion】LDH, CRP and LYM are valuable for early assessment of COVID-19, and their combined analysis can improve the effectiveness of early judgment of COVID-19 severity, which has certain significance for early clinical identification of severe COVID-19.

Key words： Coronavirus Infections Pneumonia,Viral C-Reactive Protein Lymphocyte Count Patient Acuity

Received: 12 March 2021

PACS:

R563.12

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2022.02.005 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2022/V39/I2/176

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