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2020 ; 8
(ä): 299
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Leucocyte Subsets Effectively Predict the Clinical Outcome of Patients With
COVID-19 Pneumonia: A Retrospective Case-Control Study
#MMPMID32626680
Gan J
; Li J
; Li S
; Yang C
Front Public Health
2020[]; 8
(ä): 299
PMID32626680
show ga
Background: The clinical characteristics of coronavirus disease 2019 (COVID-19)
have been well-studied, while effective predictors for clinical outcome and
research on underlying mechanisms are scarce. Methods: Hospitalized COVID-19
pneumonia patients with definitive clinical outcome (cured or died) were
retrospectively studied. The diagnostic performance of the leucocyte subsets and
other parameters were compared using the area under the receiver operating
characteristic curve (AUC). Further, the correlations between leucocyte subsets
and inflammation-related factors associated with clinical outcome were
subsequently investigated. Results: Among 95 subjects included, 56 patients were
cured, and 39 died. Older age, elevated aspartate aminotransferase, total
bilirubin, serum lactate dehydrogenase, blood urea nitrogen, prothrombin time,
D-dimer, Procalcitonin, and C-reactive protein levels, decreased albumin,
elevated serum cytokines (IL2R, IL6, IL8, IL10, and TNF-?) levels, and a
decreased lymphocyte count indicated poor outcome in patients with COVID-19
pneumonia. Lymphocyte subset (lymphocytes, T cells, helper T cells, suppressor T
cells, natural killer cells, T cells+B cells+NK cells) counts were positively
associated with clinical outcome (AUC: 0.777; AUC: 0.925; AUC: 0.900; AUC: 0.902;
AUC: 0.877; AUC: 0.918, resp.). The neutrophil-to-lymphocyte ratio (NLR),
neutrophil to T lymphocyte count ratio (NTR), neutrophil percentage to T
lymphocyte ratio (NpTR) effectively predicted mortality (AUC: 0.900; AUC: 0.905;
AUC: 0.932, resp.). Binary logistic regression showed that NpTR was an
independent prognostic factor for mortality. Serum IL6 levels were positively
correlated with leucocyte count, neutrophil count, and eosinophil count and
negatively correlated with lymphocyte count. Conclusion: These results indicate
that leucocyte subsets predict the clinical outcome of patients with COVID-19
pneumonia with high efficiency. Non-self-limiting inflammatory response is
involved in the development of fatal pneumonia.