严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染正在全球蔓延。衡量疾病的预防和控制已成为迫切需要关注的问题。
基于武汉2019年冠状病毒病(COVID-19)的临床数据,我们进行了深入的分析,以阐明该疾病的一些病理机制,并确定早期预测其严重程度的简单措施.
共招募了230例非轻度COVID-19患者,以及有关其临床特征的信息,炎性细胞因子,收集T淋巴细胞亚群。严重程度的危险因素通过二元逻辑回归分析,以及中性粒细胞与淋巴细胞比率(N/LRs)与疾病严重程度的关联,病程,CT分级,炎性细胞因子,并对T淋巴细胞亚群进行评价。
我们的结果表明,N/LRs与白细胞介素(IL)-6和IL-10密切相关(P<0.001,P=0.024),与CD3和CD8T淋巴细胞密切相关(P<0.001,P=0.046)。特别是,N/LRs与病情严重程度和病程呈正相关(P=0.021,P<0.001)。与入院后第一次测试的值相比,IL-6和IL-10显著降低和升高,分别,截至出院前最后一次测试(P=0.006,P<0.001)。更重要的是,通过二元逻辑回归,我们发现男性,基础疾病(如心血管疾病),脉搏,N/LRs均与病情严重程度密切相关(P=0.004,P=0.012,P=0.013,P=0.028)。
作为一种快速、方便的炎症标志物,N/LRs可以预测非轻度COVID-19的病程和严重程度;男性,心血管疾病,和脉搏也是非轻度COVID-19严重程度的危险因素。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is spreading worldwide. Measuring the prevention and control of the disease has become a matter requiring urgent focus.
Based on coronavirus disease 2019 (COVID-19) clinical data from Wuhan, we conducted an in-depth analysis to clarify some of the pathological mechanisms of the disease and identify simple measures to predict its severity early on.
A total of 230 patients with non-mild COVID-19 were recruited, and information on their clinical characteristics, inflammatory cytokines, and T lymphocyte subsets was collected. Risk factors for severity were analyzed by binary logistic regression, and the associations of neutrophil-to-lymphocyte ratios (N/LRs) with illness severity, disease course, CT grading, inflammatory cytokines, and T lymphocyte subsets were evaluated.
Our results showed that the N/LRs were closely related to interleukin (IL)-6 and IL-10 (P < 0.001, P = 0.024) and to CD3+ and CD8+ T lymphocytes (P < 0.001, P = 0.046). In particular, the N/LRs were positively correlated with the severity and course of the disease (P = 0.021, P < 0.001). Compared to the values at the first test after admission, IL-6 and IL-10 were significantly decreased and increased, respectively, as of the last test before discharge (P = 0.006, P < 0.001). More importantly, through binary logistic regression, we found that male sex, underlying diseases (such as cardiovascular disease), pulse, and N/LRs were all closely related to the severity of the disease (P = 0.004, P = 0.012, P = 0.013, P = 0.028).
As a quick and convenient marker of inflammation, N/LRs may predict the disease course and severity level of non-mild COVID-19; male sex, cardiovascular disease, and pulse are also risk factors for the severity of non-mild COVID-19.