Validation of Predictors of Disease Severity and Outcomes in COVID-19 Patients: A Descriptive and Retrospective Study
Validation of Predictors of Disease Severity and Outcomes in COVID-19 Patients: A Descriptive and Retrospective Study
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COVID-19 患者疾病严重程度和结果的预测因素的验证：一项描述性和回顾性研究。
DOI：
10.1016/j.medj.2020.05.002
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发表时间：
2020-12-18
期刊：
影响因子：
17
通讯作者：
Miao, Hongming
中科院分区：
文献类型：
--
作者：
Li Tan;Kang, Xia;Miao, Hongming
背景资料：COVID-19病例的严重程度和结局与循环淋巴细胞百分比（LYM %）、C反应蛋白（CRP）、白细胞介素-6（IL-6）、降钙素原（PCT）、乳酸（LA）和病毒载量（ORF1ab Ct）水平相关。然而，这些指标在疾病分类和预后中的预测能力在很大程度上仍然不清楚。方法：我们回顾性收集了142例COVID-19患者的上述参数信息，根据生存或疾病严重程度对他们进行分层。结果：CRP，PCT，IL-6，LYM %和ORF1ab Ct在幸存者和非幸存者之间有显著变化。LYM %、CRP和IL-6是区分存活者和死亡者最敏感和可靠的指标。这些指标在危重患者和重度/中度患者之间存在显著差异。只有LYM %水平在重度和中度之间存在显著差异。结论：CRP、PCT、IL-6、LYM %和ORF1ab Ct对COVID-19患者的预后有一定的预测作用，但对LA无明显影响。LYM %是预测疾病分型和预后的最敏感、最可靠的指标。我们建议在COVID-19管理中进一步调查LYM %。
Background: The severity and outcome of COVID-19 cases has been associated with the percentage of circulating lymphocytes (LYM%), levels of C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), lactic acid ( LA), and viral load (ORF1ab Ct). However, the predictive power of each of these indicators in disease classification and prognosis remains largely unclear.Methods: We retrospectively collected information on the above parameters in 142 patients with COVID-19, stratifying them by survival or disease severity.Findings: CRP, PCT, IL-6, LYM%, and ORF1ab Ct were significantly altered between survivors and non-survivors. LYM%, CRP, and IL-6 were the most sensitive and reliable factors in distinguishing between survivors and non-survivors. These indicators were significantly different between critically ill and severe/moderate patients. Only LYM% levels were significantly different between severe and moderate types. Among all the investigated indicators, LYM% was the most sensitive and reliable in discriminating between critically ill, severe, and moderate types and between survivors and non-survivors.Conclusions: CRP, PCT, IL- 6, LYM%, and ORF1ab Ct, but not LA, could predict prognosis and guide classification of COVID-19 patients. LYM% was the most sensitive and reliable predictor for disease typing and prognosis. We recommend that LYM% be further investigated in the management of COVID-19.