■实验室标志物,如淋巴细胞减少症,血小板减少症,D-二聚体升高,和C反应蛋白(CRP)预测2019年冠状病毒病(COVID-19)的预后较差。然而,缺乏基于发热状态的血液学和凝血参数变化的综合分析.
■这项回顾性研究分析了2020年3月至12月住院的300例COVID-19患者。人口统计,临床,和实验室数据从电子病历中提取。将患者分为发热组(n=200)和无发热组(n=100)。血液学,凝血,使用适当的统计检验比较各组之间的炎症标志物。多因素回归确定了发热的独立预测因子。
■发热与白细胞增多有关,嗜中性粒细胞增多症,淋巴细胞减少,血小板减少症,CRP升高,D-二聚体,降钙素原,白细胞介素-6,中性粒细胞与淋巴细胞比率(NLR),和铁蛋白相比无发热(均P<0.05)。D-二聚体(r=0.42),CRP(r=0.52),NLR(r=0.48),白细胞介素-6(r=0.46)与发热的相关性最强(P<0.001)。高D-二聚体>1000ng/mL(调整后的比值比2.7),CRP>100mg/L(3.1),淋巴细胞减少<1.0×109/L(2.8),NLR>4(2.9),和血小板减少<150×109/L(2.7)是发热状态的显著独立预测因子(P<0.005)。这些参数对于区分AUC为0.85的发热患者具有中等灵敏度(40-60%)和高特异性(74-88%)。
■血液学,凝血,和炎症标志物出现在COVID-19中,基于发烧。常规实验室参数可以促进诊断和风险分层。
UNASSIGNED: Laboratory markers like
lymphopenia, thrombocytopenia, elevated D-dimer, and C-reactive protein (CRP) predict worse outcomes in coronavirus disease 2019 (COVID-19). However, a comprehensive analysis of hematologic and coagulation parameter alterations based on fever status is lacking.
UNASSIGNED: This retrospective study analyzed 300 COVID-19 patients hospitalized from March to December 2020. Demographic, clinical, and laboratory data were extracted from electronic medical records. Patients were stratified into fever (n = 200) and no fever (n = 100) groups. Hematologic, coagulation, and inflammatory markers were compared between groups using appropriate statistical tests. Multivariate regression identified independent predictors of fever.
UNASSIGNED: Fever was associated with leukocytosis, neutrophilia,
lymphopenia, thrombocytopenia, elevated CRP, D-dimer, procalcitonin, interleukin-6, neutrophil to lymphocyte ratio (NLR), and ferritin compared to no fever (all P < 0.05). D-dimer (r = 0.42), CRP (r = 0.52), NLR (r = 0.48), and interleukin-6 (r = 0.46) demonstrated the strongest correlation with fever (P < 0.001). High D-dimer >1000 ng/mL (adjusted odds ratio 2.7), CRP >100 mg/L (3.1),
lymphopenia <1.0 × 109/L (2.8), NLR >4 (2.9), and thrombocytopenia <150 × 109/L (2.7) were significant independent predictors of fever status (P < 0.005). These parameters had moderate sensitivity (40-60%) and high specificity (74-88%) for discriminating febrile patients with AUC of 0.85.
UNASSIGNED: Marked alterations in hematologic, coagulation, and inflammatory markers occur in COVID-19 based on fever. Routine laboratory parameters can facilitate diagnosis and risk stratification.