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血小板与淋巴细胞比值与新型冠状病毒肺炎患者预后相关。

Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19.

机构信息

Department of Critical Care Medicine, Huizhou Municipal Central Hospital, Huizhou, China.

Department of Hematology and Oncology, National Cancer Center/National Clinical Research Cancer for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.

出版信息

J Med Virol. 2020 Sep;92(9):1533-1541. doi: 10.1002/jmv.25767. Epub 2020 Mar 26.

Abstract

Since December 2019, novel coronavirus infected pneumonia emerged in Wuhan city and rapidly spread throughout China. In severe novel coronavirus pneumonia cases, the number of platelets, their dynamic changes during the treatment, platelet-to-lymphocyte ratio (PLR) were a concern. We sought to describe the platelet feature of these cases. Single-center case series of the 30 hospitalized patients with confirmed coronavirus disease (COVID)-19 in Huizhou municipal central hospital from January 2020 to February 2020 were retrospectively analyzed. Demographic, clinical, blood routine results, other laboratory results, and treatment data were collected and analyzed. Outcomes of severe patients and nonsevere patients were compared. Univariate analysis showed that: age, platelet peaks, and PLR at peak platelet were the influencing factors in severe patients, multivariate analysis showed that the PLR value at peak platelet during treatment was an independent influencing factor in severe patients. The average hospitalization day of patients with platelet peaks during treatment was longer than those without platelet peaks (P < .05). The average age of patients with platelet peaks during treatment was older than those without platelet peaks (P < .05). The patients with significantly elevated platelets during treatment had longer average hospitalization days. And the higher PLR of patients during treatment had longer average hospitalization days. Single-center case series of the 30 hospitalized patients with confirmed COVID-19 in Huizhou Municipal Central Hospital, presumed that the number of platelets and their dynamic changes during the treatment may have a suggestion on the severity and prognosis of the disease. The patient with markedly elevated platelets and longer average hospitalization days may be related to the cytokine storm. The PLR of patients means the degree of cytokine storm, which might provide a new indicator in the monitoring in patients with COVID-19.

摘要

自 2019 年 12 月以来,新型冠状病毒引发的肺炎在武汉市出现,并迅速在中国各地蔓延。在严重的新型冠状病毒性肺炎病例中,血小板数量、治疗过程中的动态变化、血小板与淋巴细胞比值(PLR)受到关注。我们旨在描述这些病例的血小板特征。对 2020 年 1 月至 2 月期间惠州市中心医院收治的 30 例确诊的新型冠状病毒疾病(COVID-19)住院患者的单中心病例系列进行回顾性分析。收集并分析了人口统计学、临床、血常规结果、其他实验室结果和治疗数据。比较了重症患者和非重症患者的结局。单因素分析显示:年龄、血小板峰值和峰值时 PLR 是重症患者的影响因素,多因素分析显示治疗过程中血小板峰值时的 PLR 值是重症患者的独立影响因素。治疗过程中有血小板峰值的患者的平均住院天数长于无血小板峰值的患者(P <.05)。治疗过程中有血小板峰值的患者的平均年龄大于无血小板峰值的患者(P <.05)。治疗过程中血小板明显升高的患者平均住院天数较长。且治疗过程中 PLR 较高的患者平均住院天数也较长。推测惠州市中心医院收治的 30 例确诊 COVID-19 的住院患者的单中心病例系列研究表明,血小板数量及其在治疗过程中的动态变化可能对疾病的严重程度和预后有提示作用。血小板明显升高且平均住院天数较长的患者可能与细胞因子风暴有关。患者的 PLR 意味着细胞因子风暴的程度,这可能为 COVID-19 患者的监测提供新的指标。

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