Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
Monocyte distribution width as a pragmatic screen for SARS-CoV-2 or influenza infection.
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DOI：
10.1038/s41598-022-24978-w
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发表时间：
2022-12-13
影响因子：
4.6
通讯作者：
Hinson, Jeremiah S.
中科院分区：
文献类型：
--
作者：
Badaki-Makun, Oluwakemi;Levin, Scott;Debraine, Arnaud;Hernried, Benjamin;Malinovska, Alexandra;Smith, Aria;Toerper, Matthew;Fenstermacher, Katherine Z. J.;Cottle, Taylor;Latallo, Malgorzata;Rothman, Richard E.;Hinson, Jeremiah S.
单核细胞分布宽度（MDW）是一种新的单核细胞活化的标志物，已知单核细胞活化发生在对病毒病原体的免疫应答中。我们的目的是确定MDW和其他白细胞参数作为SARS-CoV-2和流感感染筛查试验的性能。这是对2020年1月至2021年7月期间在急诊科（艾德）接受全血细胞计数（CBC）和SARS-CoV-2或流感检测的成人患者进行的前瞻性队列分析。主要结局为SARS-CoV-2或流感感染。次要结局是疾病严重程度的测量，包括住院治疗、重症监护入院、住院时间和死亡率。评价了单核细胞百分比、MDW、白色血细胞（WBC）计数和中性粒细胞/淋巴细胞比值（NLR）的描述性统计量和检测性能指标。纳入了3，425例艾德患者访视。在1，922次访问期间进行了SARS-CoV-2检测，阳性率为5.4%;在2，090次访问期间进行了流感检测，阳性率为2.3%。感染SARS-Cov-2（中位数23.0U; IQR 20.5-25.1）或流感（中位数24.1U; IQR 22.0-26.9）的患者MDW高于未感染者（中位数18.9U; IQR 17.4-20.7和19.1U; 17.4-21，P < 0.001）。在任一病毒检测阳性的患者中，单核细胞百分比、WBC和NLR值均在正常范围内。MDW识别SARS-CoV-2和流感阳性患者的曲线下面积（AUC）分别为0.83（95%CI 0.79-0.86）和0.83（95%CI 0.77-0.88）。在MDW的可接受临界值20 U时，SARS-CoV-2和流感的灵敏度分别为83.7%（95% CI 76.5-90.8%）和89.6%（95% CI 80.9-98.2%），而单核细胞百分比、WBC和NLR的灵敏度低于45%。MDW阴性预测值分别为98.6%（95%CI 98.0-99.3%）和99.6%（95%CI 99.3-100.0%）。单核细胞分布宽度（MDW）作为常规全血细胞计数（CBC）的一部分，可能是SARS-CoV-2或流感感染的有用指标。
Monocyte distribution width (MDW) is a novel marker of monocyte activation, which is known to occur in the immune response to viral pathogens. Our objective was to determine the performance of MDW and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. This was a prospective cohort analysis of adult patients who underwent complete blood count (CBC) and SARS-CoV-2 or influenza testing in an Emergency Department (ED) between January 2020 and July 2021. The primary outcome was SARS-CoV-2 or influenza infection. Secondary outcomes were measures of severity of illness including inpatient hospitalization, critical care admission, hospital lengths of stay and mortality. Descriptive statistics and test performance measures were evaluated for monocyte percentage, MDW, white blood cell (WBC) count, and neutrophil to lymphocyte ratio (NLR). 3,425 ED patient visits were included. SARS-CoV-2 testing was performed during 1,922 visits with a positivity rate of 5.4%; influenza testing was performed during 2,090 with a positivity rate of 2.3%. MDW was elevated in patients with SARS-Cov-2 (median 23.0U; IQR 20.5–25.1) or influenza (median 24.1U; IQR 22.0–26.9) infection, as compared to those without (18.9U; IQR 17.4–20.7 and 19.1U; 17.4–21, respectively, P < 0.001). Monocyte percentage, WBC and NLR values were within normal range in patients testing positive for either virus. MDW identified SARS-CoV-2 and influenza positive patients with an area under the curve (AUC) of 0.83 (95% CI 0.79–0.86) and 0.83 (95% CI 0.77–0.88), respectively. At the accepted cut-off value of 20U for MDW, sensitivities were 83.7% (95% CI 76.5–90.8%) for SARS-CoV-2 and 89.6% (95% CI 80.9–98.2%) for influenza, compared to sensitivities below 45% for monocyte percentage, WBC and NLR. MDW negative predictive values were 98.6% (95% CI 98.0–99.3%) and 99.6% (95% CI 99.3–100.0%) respectively for SARS-CoV-2 and influenza. Monocyte Distribution Width (MDW), available as part of a routine complete blood count (CBC) with differential, may be a useful indicator of SARS-CoV-2 or influenza infection.
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发表时间：
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影响因子：
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