Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy
Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy
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DOI：
10.1515/cclm-2020-0459
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发表时间：
2020-07-01
影响因子：
6.8
通讯作者：
Lippi, Giuseppe
中科院分区：
文献类型：
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作者：
Bonetti, Graziella;Manelli, Filippo;Lippi, Giuseppe
背景：关于实验室检测的综合信息已公布，这些检测可能预测2019年亚洲冠状病毒感染人群的更糟糕结果(新冠肺炎)。本研究的目的是描述瓦卡莫尼察地区一组意大利新冠肺炎患者的实验室结果，以及异常与疾病严重程度的相关性。方法：最终研究人群包括2020年3月1日至30日在瓦卡莫尼卡医院确诊的144名新冠肺炎患者(其中70人在住院期间死亡，74人存活并可出院)。结果：与最终出院的患者相比，住院期间死亡的患者血糖、天冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、尿素、肌酐、高敏心肌肌钙蛋白I(HscTnI)、凝血酶原时间/国际标准化比值(PT/INR)、活化部分凝血活酶时间(APTT)、D-二聚体、C反应蛋白(CRP)、铁蛋白和白细胞(尤其是中性粒细胞)的值显著升高血红蛋白和淋巴细胞均显著降低。在多元回归分析中，LDH、CRP、中性粒细胞、淋巴细胞、白蛋白、APTT和年龄仍然是住院死亡的显著预测因素。合并这些变量的回归模型解释了住院死亡总方差的80%。结论：在居住在瓦尔卡莫尼卡的欧洲新冠肺炎患者的子集中，这里描述的最重要的实验室异常对住院死亡有很高的预测作用，可能有助于指导风险评估和临床决策。
Background: Comprehensive information has been published on laboratory tests which may predict worse outcome in Asian populations with coronavirus disease 2019 (COVID-19). The aim of this study is to describe laboratory findings in a group of Italian COVID-19 patients in the area of Valcamonica, and correlate abnormalities with disease severity.Methods: The final study population consisted of 144 patients diagnosed with COVID-19 (70 who died during hospital stay and 74 who survived and could be discharged) between March 1 and 30, 2020, in Valcamonica Hospital. Demographical, clinical and laboratory data were collected upon hospital admission and were then correlated with outcome (i.e. in-hospital death vs. discharge).Results: Compared to patients who could be finally discharged, those who died during hospital stay displayed significantly higher values of serum glucose, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), urea, creatinine, high-sensitivity cardiac troponin I (hscTnI), prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), D-dimer, C reactive protein (CRP), ferritin and leukocytes (especially neutrophils), whilst values of albumin, hemoglobin and lymphocytes were significantly decreased. In multiple regression analysis, LDH, CRP, neutrophils, lymphocytes, albumin, APTT and age remained significant predictors of in-hospital death. A regression model incorporating these variables explained 80% of overall variance of in-hospital death.Conclusions: The most important laboratory abnormalities described here in a subset of European COVID-19 patients residing in Valcamonica are highly predictive of in-hospital death and may be useful for guiding risk assessment and clinical decision-making.