Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID-19): A multicenter, cross-sectional study
Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID-19): A multicenter, cross-sectional study
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外周血液学标志物对 2019 年冠状病毒病 (COVID-19) 的诊断价值：一项多中心、横断面研究
DOI：
10.1002/jcla.23475
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发表时间：
2020-07-17
影响因子：
2.7
通讯作者：
Wang, Daoxin
中科院分区：
文献类型：
--
作者：
Peng, Junnan;Qi, Di;Wang, Daoxin
背景确定血液学标志物对2019冠状病毒病（COVID-19）的诊断价值，并探讨其与疾病严重程度的关系。方法研究对象包括190例COVID-19患者、190例健康受试者和105例流感肺炎（IP）患者。COVID-19患者分为ARDS组和非ARDS组。记录血常规、生化指标、住院天数、体温、肺炎严重指数（PSI）、CURB-65、MuLBSTA。使用斯皮尔曼相关分析评估变量之间的相关性。受试者工作特征（ROC）曲线用于研究各种诊断试验的准确性。结果与健康受试者相比，COVID-19患者的白色血细胞（WBC）、淋巴细胞、血小板和血红蛋白水平较低;中性粒细胞和单核细胞百分比较高;淋巴细胞百分比较低，嗜中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和血小板与淋巴细胞比率（PLR）值较高（P <0.05）。与IP相比，COVID-19患者的WBC和中性粒细胞水平较高，淋巴细胞百分比较低（P < .05）。ROC曲线分析显示，MLR在区分COVID-19患者与健康受试者方面具有较高的诊断价值，但与IP患者的诊断价值不高。NLR与PSI、CURB-65和MuLBSTA呈显著正相关。淋巴细胞计数在ARDS组较低，并产生了较高的诊断价值比其他变量。结论单核细胞/淋巴细胞比值在区分COVID-19患者和健康受试者方面显示出可接受的效率，但未能排除IP患者。NLR可能是评估COVID-19疾病严重程度的可靠标志物。淋巴细胞计数可能有助于COVID-19患者中ARDS的早期诊断。
Background To determine the diagnostic value of hematologic markers for coronavirus disease 2019 (COVID-19) and explore their relationship with disease severity. Methods Subjects included 190 COVID-19 patients, 190 healthy subjects, and 105 influenza pneumonia (IP) patients. COVID-19 patients were divided into the ARDS and non-ARDS groups. Routine blood examination, biochemistry indicator, days in hospital, body temperature, pneumonia severity index (PSI), CURB-65, and MuLBSTA were recorded. Correlations between variables were assessed using Spearman's correlation analysis. Receiver operating characteristic (ROC) curves were used to study the accuracy of the various diagnostic tests. Results Compared with healthy subjects, COVID-19 patients had lower white blood cell (WBC), lymphocyte, platelet, and hemoglobin levels; higher percentages of neutrophils and monocytes; lower percentages of lymphocytes and higher neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) values (P < .05). COVID-19 patients had higher WBC and neutrophil levels and lower percentages of lymphocytes compared to IP (P < .05). ROC curve analysis revealed that MLR had a high diagnostic value in differentiating COVID-19 patients from healthy subjects, but not from IP patients. NLR showed significant positive correlations with PSI, CURB-65, and MuLBSTA. Lymphocyte count was lower in the ARDS group and yielded a higher diagnostic value than the other variables. Conclusions Monocyte-to-lymphocyte ratio showed an acceptable efficiency to separate COVID-19 patients from healthy subjects, but failed to rule out IP patients. NLR may be a reliable marker to evaluate the disease severity of COVID-19. Lymphocyte count may be useful to establish the early diagnosis of ARDS in the COVID-19 patients.