Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19.
Temporal changes in laboratory markers of survivors and non-survivors of adult inpatients with COVID-19.
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COVID-19 成年住院患者的幸存者和非幸存者实验室标记物的时间变化。
DOI：
10.1186/s12879-020-05678-0
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发表时间：
2020-12-11
影响因子：
3.7
通讯作者：
Chen X
中科院分区：
文献类型：
--
作者：
Ouyang SM;Zhu HQ;Xie YN;Zou ZS;Zuo HM;Rao YW;Liu XY;Zhong B;Chen X
2019年冠状病毒病（COVID-19）由严重急性呼吸道综合征冠状病毒2引起，全球范围内发生疫情。实验室检测结果是临床医生判断患者病情、制定治疗方案的重要依据。编制了2020年1月16日至2020年3月18日期间在武汉市第五医院住院的确诊为COVID-19的成年住院患者的52，644份连续数值的实验室检测结果。存活组与非存活组的首末次检测结果比较采用方差检验或Welch检验。然后将具有显著差异的实验室检查变量纳入时间变化分析。在82名COVID-19幸存者和25名非幸存者的94个实验室检查变量中，白色血细胞计数、中性粒细胞计数/百分比、平均血小板体积、血小板分布宽度、血小板-大细胞百分比、超敏C反应蛋白、降钙素原、D-二聚体、纤维蛋白（原）降解产物、中荧光网织红细胞百分比、未成熟网织红细胞分数、乳酸脱氢酶显著升高（P < 0.05），淋巴细胞计数/百分比、单核细胞百分比、嗜酸性粒细胞百分比、凝血酶原活动度、低荧光网织红细胞百分比、血浆二氧化碳、总钙、前白蛋白、总蛋白、白蛋白、白球比、胆碱酯酶、总胆固醇、非高密度/低密度/小密度-低密度脂蛋白胆固醇在第一次和最后一次试验中均显著低于存活者（P < 0.05）。凝血酶原时间、凝血酶原国际标准化比值、有核红细胞计数/百分比、高荧光网织红细胞百分比、血浆尿酸、血浆尿素氮、胱抑素C、钠、磷、镁、肌红蛋白、肌酸激酶（同工酶）、天冬氨酸转氨酶、碱性磷酸酶、葡萄糖、甘油三酯显著升高（P < 0.05），以及嗜酸性粒细胞计数、嗜碱性粒细胞百分比、血小板计数、血小板压积、抗凝血酶III、红细胞计数、血红蛋白、红细胞压积、总二氧化碳、酸碱度、实际碳酸氢根、细胞外液室中的碱过量、估计的肾小球滤过率，高密度脂蛋白胆固醇、载脂蛋白A1/ B在死亡组较存活组显著降低（P < 0.05），但仅在最后一次检测时降低。淋巴细胞计数/百分比、中性粒细胞计数/百分比和血小板计数等26个变量的时间变化在存活者和非存活者之间存在明显差异。通过综合使用具有不同时间变化的实验室标志物，可以识别出具有高风险的COVID-19相关死亡或从轻度疾病进展为重度疾病的患者，以便及时进行针对性治疗。在线版本包含补充材料，可通过10.1186/s12879-020-05678-0获得。
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, and outbreaks have occurred worldwide. Laboratory test results are an important basis for clinicians to determine patient condition and formulate treatment plans. Fifty-two thousand six hundred forty-four laboratory test results with continuous values of adult inpatients who were diagnosed with COVID-19 and hospitalized in the Fifth Hospital in Wuhan between 16 January 2020 and 18 March 2020 were compiled. The first and last test results were compared between survivors and non-survivors with variance test or Welch test. Laboratory test variables with significant differences were then included in the temporal change analysis. Among 94 laboratory test variables in 82 survivors and 25 non-survivors with COVID-19, white blood cell count, neutrophil count/percentage, mean platelet volume, platelet distribution width, platelet-large cell percentage, hypersensitive C-reactive protein, procalcitonin, D-dimer, fibrin (ogen) degradation product, middle fluorescent reticulocyte percentage, immature reticulocyte fraction, lactate dehydrogenase were significantly increased (P < 0.05), and lymphocyte count/percentage, monocyte percentage, eosinophil percentage, prothrombin activity, low fluorescent reticulocyte percentage, plasma carbon dioxide, total calcium, prealbumin, total protein, albumin, albumin-globulin ratio, cholinesterase, total cholesterol, nonhigh-density/low-density/small-dense-low-density lipoprotein cholesterol were significantly decreased in non-survivors compared with survivors (P < 0.05), in both first and last tests. Prothrombin time, prothrombin international normalized ratio, nucleated red blood cell count/percentage, high fluorescent reticulocyte percentage, plasma uric acid, plasma urea nitrogen, cystatin C, sodium, phosphorus, magnesium, myoglobin, creatine kinase (isoenzymes), aspartate aminotransferase, alkaline phosphatase, glucose, triglyceride were significantly increased (P < 0.05), and eosinophil count, basophil percentage, platelet count, thrombocytocrit, antithrombin III, red blood cell count, haemoglobin, haematocrit, total carbon dioxide, acidity-basicity, actual bicarbonate radical, base excess in the extracellular fluid compartment, estimated glomerular filtration rate, high-density lipoprotein cholesterol, apolipoprotein A1/ B were significantly decreased in non-survivors compared with survivors (P < 0.05), only in the last tests. Temporal changes in 26 variables, such as lymphocyte count/percentage, neutrophil count/percentage, and platelet count, were obviously different between survivors and non-survivors. By the comprehensive usage of the laboratory markers with different temporal changes, patients with a high risk of COVID-19-associated death or progression from mild to severe disease might be identified, allowing for timely targeted treatment. The online version contains supplementary material available at 10.1186/s12879-020-05678-0.
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