The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China
The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China
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DOI：
10.1016/j.thromres.2020.05.006
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发表时间：
2020-08-01
影响因子：
7.5
通讯作者：
Yu, Xin
中科院分区：
文献类型：
--
作者：
Fu, Jianhon;Kong, Jindan;Yu, Xin
目的：探讨苏州市2019冠状病毒病（COVID-19）病例的临床特征。从血液学参数中筛选出生物标志物进行危险分层。方法：纳入苏州市确诊的COVID-19成人患者。收集患者数据，并在轻/中度和重度COVID-19组之间比较实验室检查结果。结果：共纳入75例患者，平均年龄46.6 ± 14岁，其中男性45例，平均年龄14岁。所有患者分为两组：轻度/中度组和重度组。重型组WBC、NLR、D-二聚体、纤维蛋白原明显高于轻、中度组（P < 0.05），淋巴细胞低于轻、中度组（P < 0.05）。ROC检验显示血液学参数的AUC大于炎症因子的AUC。第1天两组淋巴细胞和纤维蛋白原水平差异有统计学意义（P < 0.05）。重度组在第1、4、14天的NLR均高于轻中度组D-二聚体在第1、7、14天均显著高于对照组（P < 0.01（P < 0.05）。结论：入院时常见的COVID-19异常血液学指标包括高纤维蛋白原血症、淋巴细胞减少、D-二聚体升高和白细胞减少，在轻度/中度和重度COVID-19组之间存在显著差异。此外，NLR和D-二聚体水平的动态变化可以区分重度COVID-19病例与轻/中度病例。
Objective: To investigate the clinical features of COVID-19 cases in Suzhou China. Biomarkers were screened out of hematological parameters for risk stratification.Method: Confirmed COVID-19 adult patients in Suzhou were included. The patient data was collected, and the results of laboratory examinations were compared between the mild/moderate and severe COVID-19 groups. A ROC was calculated to compare the diagnostic performance of candidate indexes, and dynamic levels of hematological indexes were compared between the two groups.Result: 75 patients were enrolled, with a mean age of 46.6 +/- 14 years, and 45 patients were male. All patients were classified into two groups: the mild/moderate group and the severe group. WBC, neutrophil to lymphocyte ratio (NLR), D-dimer, and fibrinogen levels of the severe group were significantly higher (P < 0.05) than the mild/moderate, and the lymphocyte was lower. The ROC test showed that the hematological parameters had a larger AUC than that of inflammatory factors. There was a significant difference in lymphocyte and fibrinogen levels between the two groups on day 1 (P < 0.05). However, NLR of the severe group was higher than the mild/moderate on days 1, 4 and 14 (P < 0.01), and so was D-dimer on days 1, 7 and 14 (P < 0.05).Conclusion: The common COVID-19 abnormal hematological indexes on admission included hyperfibrinogenemia, lymphopenia, the elevation of D-dimer, and leukopenia, which were significantly different between the mild/moderate and severe COVID-19 groups. Furthermore, the dynamic change of NLR and D-dimer level can distinguish severe COVID-19 cases from the mild/moderate.