Neutrophil-to-Lymphocyte Ratios Are Closely Associated With the Severity and Course of Non-mild COVID-19
Neutrophil-to-Lymphocyte Ratios Are Closely Associated With the Severity and Course of Non-mild COVID-19
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DOI：
10.3389/fimmu.2020.02160
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发表时间：
2020-09-02
影响因子：
7.3
通讯作者：
Zhou, Jian
中科院分区：
文献类型：
--
作者：
Qun, Sen;Wang, Yulan;Zhou, Jian
背景 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染正在全球范围内传播。衡量疾病的预防和控制已成为迫切需要关注的问题。目的 根据武汉2019冠状病毒病（COVID-19）的临床数据，我们进行了深入分析，以阐明该疾病的一些病理机制，并找到早期预测其严重程度的简单措施。方法 共招募230例非轻型COVID-19患者，收集其临床特征、炎性细胞因子、T淋巴细胞亚群等信息。通过二元 Logistic 回归分析严重程度的危险因素，并评估中性粒细胞与淋巴细胞比率 (N/LR) 与疾病严重程度、病程、CT 分级、炎症细胞因子和 T 淋巴细胞亚群的关联。结果N/LRs与白细胞介素(IL)-6和IL-10(P<0.001,P=0.024)以及CD3(+)和CD8(+)T淋巴细胞(P<0.001,P=0.046)密切相关。特别是，N/LR与疾病的严重程度和病程呈正相关（P=0.021，P<0.001）。与入院后第一次检测的值相比，出院前最后一次检测的IL-6和IL-10分别显着降低和升高（P=0.006，P<0.001）。更重要的是，通过二元Logistic回归，我们发现男性、基础疾病（如心血管疾病）、脉搏、N/LRs均与疾病的严重程度密切相关（P=0.004，P=0.012，P=0.013，P=0.028）。结论 N/LRs 作为一种快速、便捷的炎症标志物，可以预测非轻度 COVID-19 的病程和严重程度；男性、心血管疾病和脉搏也是非轻度 COVID-19 严重程度的危险因素。
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is spreading worldwide. Measuring the prevention and control of the disease has become a matter requiring urgent focus. Objective Based on coronavirus disease 2019 (COVID-19) clinical data from Wuhan, we conducted an in-depth analysis to clarify some of the pathological mechanisms of the disease and identify simple measures to predict its severity early on. Methods A total of 230 patients with non-mild COVID-19 were recruited, and information on their clinical characteristics, inflammatory cytokines, and T lymphocyte subsets was collected. Risk factors for severity were analyzed by binary logistic regression, and the associations of neutrophil-to-lymphocyte ratios (N/LRs) with illness severity, disease course, CT grading, inflammatory cytokines, and T lymphocyte subsets were evaluated. Results Our results showed that the N/LRs were closely related to interleukin (IL)-6 and IL-10 (P< 0.001,P= 0.024) and to CD3(+)and CD8(+)T lymphocytes (P< 0.001,P= 0.046). In particular, the N/LRs were positively correlated with the severity and course of the disease (P= 0.021,P< 0.001). Compared to the values at the first test after admission, IL-6 and IL-10 were significantly decreased and increased, respectively, as of the last test before discharge (P= 0.006,P< 0.001). More importantly, through binary logistic regression, we found that male sex, underlying diseases (such as cardiovascular disease), pulse, and N/LRs were all closely related to the severity of the disease (P= 0.004,P= 0.012,P= 0.013,P= 0.028). Conclusions As a quick and convenient marker of inflammation, N/LRs may predict the disease course and severity level of non-mild COVID-19; male sex, cardiovascular disease, and pulse are also risk factors for the severity of non-mild COVID-19.