Clinical values of laboratory inflammation indicators for diagnosis and treatment of COVID-19 patients
10.3760/cma.j.cn112866-20200409-00120
- VernacularTitle:实验室炎症指标在COVID-19患者诊疗中的临床价值
- Author:
Dagang WANG
1
;
Weijie LI
;
Fangfang JIN
;
Shuang WANG
;
Jiyun SUN
;
Chun ZHOU
;
Fei XU
;
Jingjing GUO
;
Yajie WANG
Author Information
1. 首都医科大学附属北京地坛医院检验科，北京 100015
- Keywords:
Lymphocyte count;
C-reactive protein;
Serum amyloid A protein;
Procalcitonin;
COVID-19
- From:
Chinese Journal of Experimental and Clinical Virology
2020;34(4):347-351
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical values of laboratory inflammation indicators including lymphocyte count, C reactive protein (CRP), serum amyloid A protein (SAA), and procalcitonin (PCT) in the diagnosis and treatment of 2019 novel corona virus disease (COVID-19) patients.Methods:The data of clinical characteristics of 77 hospitalized COVID-19 patients were collected from February to March 2020. According to the guidelines for diagnosis and management of COVID-19, these patients were divided into moderate type (49 cases) and severe type (28 cases). Among them 19 cases were discharged. The differences of lymphocyte count, CRP, SAA and PCT among moderate, severe and discharged groups were compared. The indicators with better predictive value for disease development and prognosis were screened out by logistic regression and receiver operating characteristic curve (ROC) analysis.Results:The severe patients had lower lymphocyte count compared to the moderate patients ( P=0.000), while their CRP ( P=0.000), SAA ( P=0.000) and PCT positive rate ( χ2=11.003, P=0.001) were significantly higher; The lymphocyte count of discharged patients was much higher than that of moderate ( P=0.001) and severe ( P=0.000) patients, while CRP ( P=0.036, P=0.000) and SAA ( P=0.002, P=0.000) were dramatically lower; Although the discharged patients had much lower PCT positive rate than severe patients ( χ2=6.891, P=0.009), they were not significantly different from moderate patients ( χ2=0.169, P=0.681). Logistic regression analysis showed that the increased SAA and CRP were both risk factors for predicting severe illness, but the decreased SAA were demonstrated as an independent indicator for discharge. The ROC curve analysis showed that the sensitivity and specificity of SAA for diagnosis of severe patients were 85.71% and 87.76%, whereas CRP were 82.14% and 93.88%. Further, the sensitivity and specificity of SAA for predicting discharge were 100% and 57.89%. Conclusions:The laboratory inflammation indicators such as lymphocyte count, CRP, SAA and PCT had important clinical significance for the diagnosis and treatment of COVID-19 patients. Among them, SAA was demonstrated as an independent indicator with high sensitivity for evaluating the disease progression and prognosis.
