{"title":"自身免疫性疾病患者 COVID-19 严重程度的预测因素：中国疫情全面控制期间的回顾性研究","authors":"Li-Ming Chen , Jian-Bin Li , Rui Wu","doi":"10.1016/j.hrtlng.2024.08.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Early identification of risk factors for adverse COVID-19 progression in patients with autoimmune diseases is crucial for patient management, but data on the Chinese population are scarce.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to identify predictors of severe COVID-19 in patients using blood cell ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and other inflammatory markers.</p></div><div><h3>Methods</h3><p>A retrospective study of 855 patients (746 females; median age 49 years) with autoimmune diseases and concurrent COVID-19 was conducted from December 2022 to February 2023 at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University. Disease severity was assessed according to the 8th edition of the National Health Commission of the People's Republic of China's COVID-19 Diagnosis and Treatment Guidelines. The clinical classification criteria group mild and moderate cases as nonsevere cases and severe and critical cases as severe cases. A multivariate logistic regression model was established to evaluate the relationships between COVID-19 severity and demographic characteristics, comorbidities, medication use, and laboratory findings.</p></div><div><h3>Results</h3><p>The PLR, NLR, and SII were significantly greater in the severe COVID-19 group than in the nonsevere group (all <em>P</em> < 0.05). In addition to classical independent clinical risk factors, increases in the PLR (OR: 1.004, 95 % CI: 1.001∼1.007, <em>p</em> = 0.001), NLR (OR: 1.180, 95 % CI: 1.041∼1.337, <em>p</em> = 0.010), and SII (OR: 0.999, 95 % CI: 0.998∼1.000, <em>p</em> = 0.005) were identified as risk factors for severe COVID-19 in patients with autoimmune diseases. After adjusting for clinical risk factors, the PLR (AUC: 0.592 vs. 0.865; <em>P</em> < 0.05), NLR (AUC: 0.670 vs. 0.866; <em>P</em> < 0.05), and SII (AUC: 0.616 vs. 0.864; <em>P</em> < 0.05) demonstrated higher predictive values.</p></div><div><h3>Conclusion</h3><p>Early prediction of severe COVID-19 in patients with autoimmune diseases can be achieved using the NLR, PLR, and SII.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 272-278"},"PeriodicalIF":2.4000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014795632400147X/pdfft?md5=ad10a960a76c9410ef1c3b0f6128dcb4&pid=1-s2.0-S014795632400147X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Predictors of COVID-19 severity in autoimmune disease patients: A retrospective study during full epidemic decontrol in China\",\"authors\":\"Li-Ming Chen , Jian-Bin Li , Rui Wu\",\"doi\":\"10.1016/j.hrtlng.2024.08.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Early identification of risk factors for adverse COVID-19 progression in patients with autoimmune diseases is crucial for patient management, but data on the Chinese population are scarce.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to identify predictors of severe COVID-19 in patients using blood cell ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and other inflammatory markers.</p></div><div><h3>Methods</h3><p>A retrospective study of 855 patients (746 females; median age 49 years) with autoimmune diseases and concurrent COVID-19 was conducted from December 2022 to February 2023 at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University. Disease severity was assessed according to the 8th edition of the National Health Commission of the People's Republic of China's COVID-19 Diagnosis and Treatment Guidelines. The clinical classification criteria group mild and moderate cases as nonsevere cases and severe and critical cases as severe cases. A multivariate logistic regression model was established to evaluate the relationships between COVID-19 severity and demographic characteristics, comorbidities, medication use, and laboratory findings.</p></div><div><h3>Results</h3><p>The PLR, NLR, and SII were significantly greater in the severe COVID-19 group than in the nonsevere group (all <em>P</em> < 0.05). In addition to classical independent clinical risk factors, increases in the PLR (OR: 1.004, 95 % CI: 1.001∼1.007, <em>p</em> = 0.001), NLR (OR: 1.180, 95 % CI: 1.041∼1.337, <em>p</em> = 0.010), and SII (OR: 0.999, 95 % CI: 0.998∼1.000, <em>p</em> = 0.005) were identified as risk factors for severe COVID-19 in patients with autoimmune diseases. After adjusting for clinical risk factors, the PLR (AUC: 0.592 vs. 0.865; <em>P</em> < 0.05), NLR (AUC: 0.670 vs. 0.866; <em>P</em> < 0.05), and SII (AUC: 0.616 vs. 0.864; <em>P</em> < 0.05) demonstrated higher predictive values.</p></div><div><h3>Conclusion</h3><p>Early prediction of severe COVID-19 in patients with autoimmune diseases can be achieved using the NLR, PLR, and SII.</p></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"68 \",\"pages\":\"Pages 272-278\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S014795632400147X/pdfft?md5=ad10a960a76c9410ef1c3b0f6128dcb4&pid=1-s2.0-S014795632400147X-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S014795632400147X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S014795632400147X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Predictors of COVID-19 severity in autoimmune disease patients: A retrospective study during full epidemic decontrol in China
Background
Early identification of risk factors for adverse COVID-19 progression in patients with autoimmune diseases is crucial for patient management, but data on the Chinese population are scarce.
Objectives
The purpose of this study was to identify predictors of severe COVID-19 in patients using blood cell ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and other inflammatory markers.
Methods
A retrospective study of 855 patients (746 females; median age 49 years) with autoimmune diseases and concurrent COVID-19 was conducted from December 2022 to February 2023 at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University. Disease severity was assessed according to the 8th edition of the National Health Commission of the People's Republic of China's COVID-19 Diagnosis and Treatment Guidelines. The clinical classification criteria group mild and moderate cases as nonsevere cases and severe and critical cases as severe cases. A multivariate logistic regression model was established to evaluate the relationships between COVID-19 severity and demographic characteristics, comorbidities, medication use, and laboratory findings.
Results
The PLR, NLR, and SII were significantly greater in the severe COVID-19 group than in the nonsevere group (all P < 0.05). In addition to classical independent clinical risk factors, increases in the PLR (OR: 1.004, 95 % CI: 1.001∼1.007, p = 0.001), NLR (OR: 1.180, 95 % CI: 1.041∼1.337, p = 0.010), and SII (OR: 0.999, 95 % CI: 0.998∼1.000, p = 0.005) were identified as risk factors for severe COVID-19 in patients with autoimmune diseases. After adjusting for clinical risk factors, the PLR (AUC: 0.592 vs. 0.865; P < 0.05), NLR (AUC: 0.670 vs. 0.866; P < 0.05), and SII (AUC: 0.616 vs. 0.864; P < 0.05) demonstrated higher predictive values.
Conclusion
Early prediction of severe COVID-19 in patients with autoimmune diseases can be achieved using the NLR, PLR, and SII.
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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