治疗后中性粒细胞与淋巴细胞比率作为接受托西珠单抗治疗的严重新冠肺炎肺炎患者的预后工具-单中心经验。

IF 3.8 3区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY
Gomerčić Palčić Marija, Matijaca Hana, Kruljac Ivan, Vusić Lucija, Hostić Vedran, Vrbanić Luka, Fanika Mrsić, Zrilić Radovan, Ćelap Ivana, Gaćina Petar
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引用次数: 0

摘要

简介:托奇利珠单抗用于重症新冠肺炎肺炎和高浓度IL-6患者。我们研究了中性粒细胞和淋巴细胞计数对tocilizumab治疗的潜在预后作用。材料和方法:我们纳入了31例严重新冠肺炎肺炎患者,他们的血清IL-6浓度较高。样品在托西利珠单抗给药当天和五天后采集。我们使用ROC分析来研究所分析的参数与30天死亡率之间的相关性,以确定最佳的治疗前和治疗后预后因素。Kaplan-Meier曲线和对数秩检验用于呈现和分析生存率的差异。结果:患者的中位年龄为63岁(55-67岁),接受了中位剂量为800 mg的托珠单抗治疗。在30天的随访期内,17名患者死亡(30天死亡率54%)。在治疗前变量中,中性粒细胞计数具有最佳的预后准确性(AUC 0.81,95%CI:0.65-0.96,P=0.004),而中性粒细胞与淋巴细胞比率(NLR)在治疗后变量中预测30天死亡率的准确性最高(AUC 0.94,95%CI:0.86-1.00,P<0.001)。在治疗后参数中,中性白细胞计数和NLR同样是良好的预后因素。治疗后NLR截止值9.8的敏感性为81%,特异性为93%。NLR≥9.8的患者的中位生存期为7.0(3-10)天,而NLR<9.8的患者中位生存率未达到(P<0.001)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Post-treatment neutrophil to lymphocyte ratio as a prognostic tool in patients treated with tocilizumab for severe COVID-19 pneumonia - a single center experience.

Post-treatment neutrophil to lymphocyte ratio as a prognostic tool in patients treated with tocilizumab for severe COVID-19 pneumonia - a single center experience.

Introduction: Tocilizumab is used in patients with severe COVID-19 pneumonia and high concentration of IL-6. We studied potential prognostic role of neutrophil and lymphocyte count regarding tocilizumab treatment.

Materials and methods: We enrolled 31 patients with severe COVID-19 pneumonia and higher serum IL-6 concentration. The samples were taken on the day of tocilizumab administration and five days later. We used ROC analysis to investigate the association between the analysed parameters and 30-day mortality in order to determine the best pre-treatment and post-treatment prognostic factor. Kaplan-Meier curves and log-rank test were used to present and to analyse the difference in survival.

Results: Patients had a median age of 63 (55-67) years and were treated with a median tocilizumab dose of 800 mg. During the 30-day follow-up period, 17 patients died (30-day mortality 54%). Among pre-treatment variables, neutrophil count had the best prognostic accuracy (AUC 0.81, 95%CI: 0.65-0.96, P = 0.004), while neutrophil to lymphocyte ratio (NLR) had the highest accuracy among post-treatment variables in predicting 30-day mortality (AUC 0.94, 95%CI: 0.86-1.00, P < 0.001). Among post-treatment parameters, neutrophil count and NLR were equally good prognostic factors. Post-treatment NLR cut-off of 9.8 had the sensitivity of 81% and specificity of 93%. Patients with NLR ≥ 9.8 had the median survival of 7.0 (3-10) days vs. median survival not reached in patients with NLR < 9.8 (P < 0.001).

Conclusion: Pre-treatment and post-treatment neutrophil count with post-treatment NLR may represent prognostic tools for patients with higher IL-6 concentration in severe COVID-19 pneumonia treated with tocilizumab.

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来源期刊
Biochemia Medica
Biochemia Medica 医学-医学实验技术
CiteScore
5.50
自引率
3.00%
发文量
70
审稿时长
>12 weeks
期刊介绍: Biochemia Medica is the official peer-reviewed journal of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Journal provides a wide coverage of research in all aspects of clinical chemistry and laboratory medicine. Following categories fit into the scope of the Journal: general clinical chemistry, haematology and haemostasis, molecular diagnostics and endocrinology. Development, validation and verification of analytical techniques and methods applicable to clinical chemistry and laboratory medicine are welcome as well as studies dealing with laboratory organization, automation and quality control. Journal publishes on a regular basis educative preanalytical case reports (Preanalytical mysteries), articles dealing with applied biostatistics (Lessons in biostatistics) and research integrity (Research integrity corner).
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