Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19
Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19
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DOI：
10.1016/j.cca.2020.06.009
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发表时间：
2020-10-01
影响因子：
5
通讯作者：
Gu, Bing
中科院分区：
文献类型：
--
作者：
Bao, Jinfeng;Li, Chenxi;Gu, Bing
背景：2019冠状病毒病（COVID-19）大流行威胁全球健康。冠状病毒的实验室表现特点对临床诊断和治疗具有重要意义。我们发现了可能最有效地预测非重症COVID-19患者发展为重症患者的指标。方法：我们进行了一项荟萃分析，比较了检索文献中重症患者与非重症COVID-19患者的实验室检查结果。结果：通过对35篇文章中COVID-19患者实验室检查信息的分析，（5912例患者），我们证明了严重病例具有较高的白细胞水平，（1.20倍），中性粒细胞（1.33倍），CRP（3.04倍），PCT（2.00倍），ESR（1.44倍），AST（1.40倍），ALT（1.34倍），LDH（1.54倍），CK（1.44倍），CK-MB（1.39倍），总胆红素（1.14倍），尿素（1.28倍），肌酸（1.09倍），PT（1.03倍）和D-二聚体（2.74倍），以及较低水平的淋巴细胞（1.44倍）、嗜酸性粒细胞（2.00倍）、单核细胞（1.08倍）、血红蛋白（1.53倍）、血小板（1.15倍）、白蛋白（1.15倍）和APTT（1.02倍）。重症患者的淋巴细胞亚群和一系列炎性细胞因子也与非重症患者不同，包括CD 4 T细胞水平降低（2.10倍）和CD 8 T细胞（2.00倍），更高水平的IL-1 β（1.02倍），IL-6（1.93倍）和IL-10（1.55倍）。某些特定的实验室检查可以预测COVID-19的进展变化，特别是淋巴细胞、CRP、PCT、ALT、AST、LDH、D-二聚体、CD 4 T细胞和IL 6，其为防止疾病恶化提供了有价值的信号。
Background: The pandemic coronavirus disease 2019 (COVID-19) has threaten the global health. The characteristics of laboratory findings of coronavirus are of great significance for clinical diagnosis and treatment. We found indicators that may most effectively predict a non-severe COVID-19 patient develop into a severe patient.Methods: We conducted a meta-analysis to compare the laboratory findings of severe patients with non-severe patients with COVID-19 from searched articles.Results: Through the analysis of laboratory examination information of patients with COVID-19 from 35 articles (5912 patients), we demonstrated that severe cases possessed higher levels of leukocyte (1.20-fold), neutrophil (1.33-fold), CRP (3.04-fold), PCT (2.00-fold), ESR (1.44-fold), AST (1.40-fold), ALT (1.34-fold), LDH (1.54-fold), CK (1.44-fold), CK-MB (1.39-fold), total bilirubin (1.14-fold), urea (1.28-fold), creatine (1.09-fold), PT (1.03-fold) and D-dimer (2.74-fold), as well as lower levels of lymphocytes (1.44-fold), eosinophil (2.00-fold), monocyte (1.08-fold), Hemoglobin (1.53-fold), PLT (1.15-fold), albumin (1.15-fold), and APTT (1.02-fold). Lymphocyte subsets and series of inflammatory cytokines were also different in severe cases with the non-severe ones, including lower levels of CD4 T cells (2.10-fold) and CD8 T cells (2.00-fold), higher levels of IL-1 beta (1.02-fold), IL-6 (1.93-fold) and IL-10 (1.55-fold).Conclusions: Some certain laboratory inspections could predict the progress of the COVID-19 changes, especially lymphocytes, CRP, PCT, ALT, AST, LDH, D-dimer, CD4 T cells and IL6, which provide valuable signals for preventing the deterioration of the disease.