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.
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。