Efficacy of monocyte distribution width in predicting critical illness in patients with COVID-19 pneumonia: a retrospective cohort study.

IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES
Chia-Hung Lai, Chun-Hung Chen, Yen-Wei Chiu, Fen-Wei Huang, Shih-Yun Wu, Hong-Mo Shih, Po-Ren Hsueh
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引用次数: 0

Abstract

Background: Identifying patients at a risk of severe COVID-19 is crucial for prompt intervention and mortality risk mitigation. The monocyte distribution width (MDW) is an effective accurate predictor of sepsis in emergency settings, facilitating timely patient management. However, few reliable laboratory parameters are available for predicting the severity and prognosis of COVID-19. Thus, this study was conducted to investigate whether MDW can accurately predict the severity and progression of COVID-19 pneumonia.

Methods: This retrospective cohort study included patients with COVID-19 pneumonia who had been admitted to our hospital between January 1, 2022, and September 31, 2022. The primary outcome was the development of critical illness, which was assessed in terms of intensive care unit (ICU) admission, need for mechanical ventilation (MV), or mortality. The secondary outcomes were durations of ICU stay, MV, and hospital stay. Multivariate logistic regression was performed to estimate the risks of critical illness and mortality.

Results: Data from 878 patients with COVID-19 were analyzed. Of these, 258 (29.4%) developed critical illness. The high-MDW group (MDW > 22) showed a higher rate of critical illness (155/452, 34.29%) compared to the low-MDW group (103/426, 24.18%). Mortality was also higher in the high-MDW group (95/452, 21.02%) than in the low-MDW group (37/426, 8.69%). Patients with MDW > 22 exhibited a significantly higher risk of developing critical illness (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.08-2.04) and mortality (aOR: 2.46; 95% CI: 1.63-3.74) compared to those with MDW ≤ 22.

Conclusion: Our findings suggest that an elevated MDW value at presentation may serve as a promising predictor of severe outcomes in patients with COVID-19 pneumonia. This underscores the need for further research to validate the utility of MDW in predicting critical illness among patients with viral pneumonia.

单核细胞分布宽度预测COVID-19肺炎危重症的疗效:一项回顾性队列研究
背景:识别有严重COVID-19风险的患者对于及时干预和降低死亡风险至关重要。单核细胞分布宽度(MDW)是紧急情况下脓毒症的有效准确预测指标,有助于及时对患者进行管理。然而,很少有可靠的实验室参数可用于预测COVID-19的严重程度和预后。因此,本研究旨在探讨MDW是否能准确预测COVID-19肺炎的严重程度和进展。方法:本回顾性队列研究纳入2022年1月1日至2022年9月31日在我院住院的COVID-19肺炎患者。主要转归是危重症的发展,根据重症监护病房(ICU)入院、机械通气(MV)需求或死亡率进行评估。次要结局为ICU住院时间、MV和住院时间。采用多变量logistic回归来估计危重疾病和死亡率的风险。结果:分析了878例COVID-19患者的数据。其中,258人(29.4%)患上了危重疾病。高MDW组(MDW bbb22)危重率(155/452,34.29%)高于低MDW组(103/426,24.18%)。高mdw组死亡率(95/452,21.02%)高于低mdw组(37/426,8.69%)。MDW bbb22患者发生危重疾病的风险显著增高(校正优势比[aOR]: 1.48;95%可信区间[CI]: 1.08-2.04)和死亡率(aOR: 2.46;95% CI: 1.63-3.74),与MDW≤22的患者相比。结论:我们的研究结果表明,发病时MDW值升高可能是COVID-19肺炎患者严重结局的一个有希望的预测指标。这强调需要进一步的研究来验证MDW在预测病毒性肺炎患者危重疾病中的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Infectious Diseases
BMC Infectious Diseases 医学-传染病学
CiteScore
6.50
自引率
0.00%
发文量
860
审稿时长
3.3 months
期刊介绍: BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
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