Can routine laboratory tests discriminate SARS-CoV-2-infected pneumonia from other causes of community-acquired pneumonia?
Can routine laboratory tests discriminate SARS-CoV-2-infected pneumonia from other causes of community-acquired pneumonia?
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DOI：
10.1002/ctm2.23
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发表时间：
2020-03-01
影响因子：
10.6
通讯作者：
Wang, Xinghuan
中科院分区：
文献类型：
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作者：
Pan, Yunbao;Ye, Guangming;Wang, Xinghuan
SARS-CoV-2感染的肺炎（COVID-19）的临床表现与其他社区获得性肺炎（CAP）的病因相似。我们的目的是确定临床实验室特征，以区分COVID-19和CAP。方法比较84例COVID-19患者和221例CAP患者入院时的血液学和生化特征。通过多变量logistic回归计算COVID-19的独立预测参数。绘制受试者工作特征（ROC）曲线，并测量ROC曲线下面积（AUC），以评价判别能力。结果COVID-19患者的血液学和生化指标与CAP患者的大多数血液学和生化指标有显著差异。确定了9项实验室参数可预测COVID-19的诊断。AUC表现出对红细胞分布宽度（RDW）（AUC为0.87）和血红蛋白（AUC为0.81）的良好区分能力。红细胞、白蛋白、嗜酸性粒细胞、红细胞压积、碱性磷酸酶和平均血小板体积具有较好的区分能力。任何两个参数的组合比单独的RDW表现更好。结论常规实验室检查有助于COVID-19的诊断。当病人出现不明原因的发热性呼吸道疾病时，实验室检测的应用可能有助于优化隔离室的使用。
Background The clinical presentation of SARS-CoV-2-infected pneumonia (COVID-19) resembles that of other etiologies of community-acquired pneumonia (CAP). We aimed to identify clinical laboratory features to distinguish COVID-19 from CAP. Methods We compared the hematological and biochemical features of 84 patients with COVID-19 at hospital admission and 221 patients with CAP. Parameters independently predictive of COVID-19 were calculated by multivariate logistic regression. The receiver operating characteristic (ROC) curves were generated and the area under the ROC curve (AUC) was measured to evaluate the discriminative ability. Results Most hematological and biochemical indexes of patients with COVID-19 were significantly different from patients with CAP. Nine laboratory parameters were identified to be predictive of a diagnosis of COVID-19. The AUCs demonstrated good discriminatory ability for red cell distribution width (RDW) with an AUC of 0.87 and hemoglobin with an AUC of 0.81. Red blood cell, albumin, eosinophil, hematocrit, alkaline phosphatase, and mean platelet volume had fair discriminatory ability. Combinations of any two parameters performed better than did the RDW alone. Conclusions Routine laboratory examinations may be helpful for the diagnosis of COVID-19. Application of laboratory tests may help to optimize the use of isolation rooms for patients when they present with unexplained febrile respiratory illnesses.