目的:本研究旨在探讨炎症细胞因子和淋巴细胞水平在预测COVID-19感染患者疾病进展中的预后意义。
方法:回顾性纳入92例住院COVID-19患者作为研究对象。一般临床信息和各种指标,包括淋巴细胞计数,白细胞介素-2(IL-2),白细胞介素-6(IL-6),白细胞介素-8(IL-8),白细胞介素-10(IL-10),肿瘤坏死因子(TNF),被收集。所有患者均按照第9版COVID-19指南进行治疗。观察28天内气管插管的发生率和死亡率。
结果:1.在分析插管影响时,多变量分析确定的年龄,免疫球蛋白,淋巴细胞,IL-6为独立危险因素。在分析对患者死亡率的影响时,多变量分析显示年龄,前白蛋白,BNP为独立危险因素。2.淋巴细胞计数和炎症因子对COVID-19患者气管插管具有预测价值。临界淋巴细胞计数值为0.91,灵敏度为38.8%,特异性为92.9%,AUC为0.687(95%CI:0.580-0.795)。IL-6的临界值为38.21,灵敏度为81%,特异性为63.3%,AUC为0.771(95%CI:0.667.872)。IL-8、IL-10和TNF的ROC曲线下面积分别为0.665、0.712和0.648。3.淋巴细胞计数和炎症因子也对COVID-19患者的死亡具有预测价值。临界淋巴细胞计数值为0.56,灵敏度为71.2%,特异性为57.5%,AUC为0.641(95%CI:0.528-0.754)。IL-6的临界值为53.05,灵敏度为75%,特异性为71.2%,AUC为0.770(95%CI:0.6690.870)。IL-8、IL-10和TNF的ROC曲线下面积分别为0.687、0.683和0.636。
结论:炎症因子升高和淋巴细胞水平降低对预测COVID-19患者气管插管和死亡率具有预后价值。为临床医生预测疾病进展提供有价值的见解。
OBJECTIVE: This study aims to investigate the prognostic significance of inflammatory cytokines and lymphocyte levels in predicting disease progression among patients with COVID-19 infection.
METHODS: Ninety-two hospitalized COVID-19 patients were retrospectively included as subjects for this study. General clinical information and various indicators, including lymphocyte count, interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor (TNF), were collected. All patients received treatment according to the ninth edition of the guidelines for COVID-19. Incidences of endotracheal intubation and mortality within 28 days were observed.
RESULTS: 1.In the analysis of intubation impact, multivariate analysis identified age, immunoglobulins, lymphocytes, and IL-6 as independent risk factors. When analyzing the impact on patient mortality, multivariate analysis revealed age, prealbumin, and BNP as independent risk factors. 2. Lymphocyte count and inflammatory factors demonstrated predictive value for endotracheal intubation in COVID-19 patients. The critical lymphocyte count value was 0.91, with a sensitivity of 38.8%, specificity of 92.9%, and AUC of 0.687 (95% CI: 0.580-0.795). The critical IL-6 value was 38.21, with a sensitivity of 81%, specificity of 63.3%, and AUC of 0.771 (95% CI: 0.6670.872). The area under the ROC curve for IL-8, IL-10 and TNF is 0.665, 0.712 and 0.648, respectively. 3.Lymphocyte count and inflammatory factors also exhibited predictive value for death in COVID-19 patients. The critical lymphocyte count value was 0.56, with a sensitivity of 71.2%, specificity of 57.5%, and AUC of 0.641 (95% CI: 0.528-0.754). The critical IL-6 value was 53.05, with a sensitivity of 75%, specificity of 71.2%, and AUC of 0.770 (95% CI: 0.6690.870). The area under the ROC curve for IL-8, IL-10 and TNF is 0.687, 0.683 and 0.636, respectively.
CONCLUSIONS: Elevated inflammatory factors and decreased lymphocyte levels have prognostic value for predicting endotracheal intubation and mortality in COVID-19 patients, providing valuable insights for clinicians in anticipating disease progression.