PDF(Pubmed)
Abstract：
BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), influenza A, and respiratory syncytial virus (RSV) infections have similar modes of transmission and clinical symptoms. There is a need to identify simple diagnostic indicators to distinguish these three infections, particularly for community hospitals and low- and middle-income countries that lack nucleic acid detection kits. This study used clinical data to assess the diagnostic value of routine blood tests in differentiating between SARS-CoV-2, influenza A, and RSV infections in children.
METHODS: A total of 1420 children treated at the Hangzhou Children\'s Hospital between December 2022 and June 2023 were enrolled in this study, of whom 351 had SARS-CoV-2, 671 had influenza, and 398 had RSV. In addition, 243 healthy children were also collected. The blood test results of SARS-CoV-2 patients were compared to those of patients with influenza A and RSV and the healthy controls. The area under the receiver operating characteristic curve (AUC-ROC) was employed to evaluate each blood parameter\'s diagnostic value.
RESULTS: Children with SARS-CoV-2 exhibited notably elevated levels of white blood cell (WBC) count, platelet (PLT) count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) compared to influenza A patients (P < 0.05). In contrast, SARS-CoV-2 patients exhibited a decrease in the mean platelet volume to platelet count ratio (MPV/PLT) and the lymphocyte-to-monocyte ratio (LMR) when compared to other individuals (P < 0.05). These parameters had an AUC between 0.5 and 0.7. Compared to patients with RSV, SARS-CoV-2 patients had significantly higher MPV/PLT and significantly lower WBC, lymphocyte, PLT, LMR, and lymphocyte multiplied by platelet (LYM*PLT) values (P < 0.05). However, only LYM*PLT had an acceptable diagnostic value above 0.7 for all age groups. Compared to healthy children, children with COVID-19 exhibited elevated NLR and MPV/PLT levels, alongside decreased lymphocyte, PLT, LMR, and LYM*PLT values. (P < 0.05). The AUC of the LMR, LYM*PLT, and PLT were above 0.7 in all age groups, indicating promising diagnostic values.
CONCLUSIONS: The routine blood parameters among patients with COVID-19, influenza A, and RSV differ significantly early in the disease and could be used by clinicians to discriminate between the 3 types of infection.
METHODS: A total of 1420 children treated at the Hangzhou Children\'s Hospital between December 2022 and June 2023 were enrolled in this study, of whom 351 had SARS-CoV-2, 671 had influenza, and 398 had RSV. In addition, 243 healthy children were also collected. The blood test results of SARS-CoV-2 patients were compared to those of patients with influenza A and RSV and the healthy controls. The area under the receiver operating characteristic curve (AUC-ROC) was employed to evaluate each blood parameter\'s diagnostic value.
RESULTS: Children with SARS-CoV-2 exhibited notably elevated levels of white blood cell (WBC) count, platelet (PLT) count, neutrophil count, and neutrophil-to-lymphocyte ratio (NLR) compared to influenza A patients (P < 0.05). In contrast, SARS-CoV-2 patients exhibited a decrease in the mean platelet volume to platelet count ratio (MPV/PLT) and the lymphocyte-to-monocyte ratio (LMR) when compared to other individuals (P < 0.05). These parameters had an AUC between 0.5 and 0.7. Compared to patients with RSV, SARS-CoV-2 patients had significantly higher MPV/PLT and significantly lower WBC, lymphocyte, PLT, LMR, and lymphocyte multiplied by platelet (LYM*PLT) values (P < 0.05). However, only LYM*PLT had an acceptable diagnostic value above 0.7 for all age groups. Compared to healthy children, children with COVID-19 exhibited elevated NLR and MPV/PLT levels, alongside decreased lymphocyte, PLT, LMR, and LYM*PLT values. (P < 0.05). The AUC of the LMR, LYM*PLT, and PLT were above 0.7 in all age groups, indicating promising diagnostic values.
CONCLUSIONS: The routine blood parameters among patients with COVID-19, influenza A, and RSV differ significantly early in the disease and could be used by clinicians to discriminate between the 3 types of infection.
摘要：
背景：严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2），甲型流感,呼吸道合胞病毒（RSV）感染具有相似的传播方式和临床症状。有必要确定简单的诊断指标来区分这三种感染，特别是对于缺乏核酸检测试剂盒的社区医院和低收入和中等收入国家。这项研究使用临床数据来评估血常规检查在区分SARS-CoV-2，甲型流感，和儿童RSV感染。
方法：本研究纳入了2022年12月至2023年6月在杭州儿童医院接受治疗的1420名儿童，其中351人患有SARS-CoV-2，671人患有流感，398人患有RSV。此外,还收集了243名健康儿童。将SARS-CoV-2患者的血液检测结果与甲型流感和RSV患者以及健康对照者的血液检测结果进行比较。采用受试者工作特征曲线下面积(AUC-ROC)评价各血液参数的诊断价值。
结果：患有SARS-CoV-2的儿童表现出明显升高的白细胞（WBC）计数水平，血小板(PLT)计数,中性粒细胞计数,中性粒细胞与淋巴细胞比值（NLR）与甲型流感患者相比（P<0.05）。相比之下,与其他个体相比，SARS-CoV-2患者的平均血小板体积与血小板计数之比（MPV/PLT）和淋巴细胞与单核细胞之比（LMR）降低（P<0.05）。这些参数的AUC在0.5和0.7之间。与RSV患者相比，SARS-CoV-2患者MPV/PLT显著增高,WBC显著降低,淋巴细胞，PLT,LMR,和淋巴细胞乘以血小板（LYM*PLT）值（P<0.05）。然而,对于所有年龄组,只有LYM*PLT的诊断值高于0.7.与健康儿童相比，患有COVID-19的儿童表现出升高的NLR和MPV/PLT水平，伴随着淋巴细胞减少，PLT,LMR,和LYM*PLT值。(P<0.05)。LMR的AUC，LYM*PLT,所有年龄组的PLT都在0.7以上，表明有希望的诊断价值。
结论：COVID-19、甲型流感、和RSV在疾病早期存在显着差异，临床医生可用于区分3种感染类型。
方法：本研究纳入了2022年12月至2023年6月在杭州儿童医院接受治疗的1420名儿童，其中351人患有SARS-CoV-2，671人患有流感，398人患有RSV。此外,还收集了243名健康儿童。将SARS-CoV-2患者的血液检测结果与甲型流感和RSV患者以及健康对照者的血液检测结果进行比较。采用受试者工作特征曲线下面积(AUC-ROC)评价各血液参数的诊断价值。
结果：患有SARS-CoV-2的儿童表现出明显升高的白细胞（WBC）计数水平，血小板(PLT)计数,中性粒细胞计数,中性粒细胞与淋巴细胞比值（NLR）与甲型流感患者相比（P<0.05）。相比之下,与其他个体相比，SARS-CoV-2患者的平均血小板体积与血小板计数之比（MPV/PLT）和淋巴细胞与单核细胞之比（LMR）降低（P<0.05）。这些参数的AUC在0.5和0.7之间。与RSV患者相比，SARS-CoV-2患者MPV/PLT显著增高,WBC显著降低,淋巴细胞，PLT,LMR,和淋巴细胞乘以血小板（LYM*PLT）值（P<0.05）。然而,对于所有年龄组,只有LYM*PLT的诊断值高于0.7.与健康儿童相比，患有COVID-19的儿童表现出升高的NLR和MPV/PLT水平，伴随着淋巴细胞减少，PLT,LMR,和LYM*PLT值。(P<0.05)。LMR的AUC，LYM*PLT,所有年龄组的PLT都在0.7以上，表明有希望的诊断价值。
结论：COVID-19、甲型流感、和RSV在疾病早期存在显着差异，临床医生可用于区分3种感染类型。
