冠状病毒轻度感染过程中一般血液检查和凝血指标的变化

N. Timofeeva, O. Kostrova, I. S. Stomenskaya, N. V. Bubnova
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引用次数: 1

摘要

2020年,一种新型冠状病毒感染的大流行在世界上几乎所有国家蔓延。这种感染的危险在于对肺部的损害,这可能导致致命的后果。治疗的成功在很大程度上取决于疾病的早期诊断和及时治疗。为了寻找冠状病毒感染的早期实验室诊断方法,我们对56例平均年龄49±2岁的门诊冠状病毒轻度感染患者(其中男性占23.2%,女性占66.8%)外周血指标、凝血指标及c反应蛋白的变化进行了研究。所有患者均通过鼻咽或口咽涂片聚合酶链反应(PCR)检测SARS-CoV-2 RNA证实冠状病毒感染。根据计算机断层扫描结果,66%的患者检测到肺损伤的迹象。所有患者红细胞数量和血红蛋白水平均正常。在7%的患者中检测到血小板减少,在5.3%的患者中检测到血小板增多。最明显的变化是在血液凝固系统的白细胞配方和指标中发现的。在没有病毒性肺炎体征的12.5%的患者中检测到白细胞增多。所有的白细胞减少病例都是在肺损伤的背景下发现的,在这一背景下,16%的淋巴细胞减少,43%的淋巴细胞增多。半数以上肺炎患者的凝血图显示活性部分凝血活酶时间(APTT)缩短,凝血酶原指数(PI)和纤维蛋白原含量升高。只有四分之一的轻度肺损伤患者c反应蛋白水平升高。因此,在凝血指标有高凝倾向的背景下,白细胞配方的变化应该引起医生在治疗与COVID-19临床症状相似的患者时的担忧态度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CHANGES IN THE INDICATORS OF THE GENERAL BLOOD TEST AND COAGULOGRAM IN A MILD COURSE OF CORONAVIRUS INFECTION
In 2020 the pandemic of a new coronavirus infection spread in almost all countries of the world. The danger of this infection lies in the damage to the lungs, which can lead to fatal outcomes. The success of treatment is largely determined by the early diagnosis of the disease and its timely treatment. In order to find the ways of early laboratory diagnosis of coronavirus infection, we studied changes in peripheral blood indicators, coagulograms and C-reactive protein in 56 outpatient patients with mild course of coronavirus infection, whose average age was 49±2 years (among them, 23.2% were men and 66.8% were women). In all patients, coronavirus infection was confirmed by the detection of SARS-CoV-2 RNA by polymerase chain reaction (PCR) in nasopharyngeal or oropharyngeal smears. Signs of lung damage were detected in 66% of patients according to computed tomography findings. The number of red blood cells and the level of hemoglobin in all patients were normal. In 7% of patients, thrombocytopenia was detected, in 5.3% of patients – thrombocytosis. The most pronounced changes are foundin the leucoformula and indicators of the blood coagulation system. In 12.5% of patients without signs of viral pneumonia, leukocytosis was detected. All cases of leukopenia were noted only against the background of lung damage, at this, in 16% lymphopenia was found, 43% had relative lymphocytosis. The coagulogram of more than half of the patients with pneumonia showed shortening of blood clotting in the activated partial thromboplastin time (APTT) test, an increase in prothrombin index(PI) and the content of fibrinogen. The level of C-reactive protein was increased in only a quarter of patients with mild lung damage. Thus, changes in the leucoformula against the background of a tendency to hypercoagulation in blood clotting indicators should cause doctors' apprehensive attitude when treating a patient with clinical symptoms similar to COVID-19.
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