| Objective To explore the value of NLR and plasma CRP in predicting the progression of adult Corona Virus Disease 2019（COVID-19）to severe disease.Methods:The data of hospitalized patients with COVID-19 from January 17,2020 to February 28,2020 in Enshi Prefecture,Hubei Province,kept by the Center for Disease Control in Enshi Prefecture,were reviewed.There were 188 cases in total,and 34 cases that did not meet the standard were excluded,and 154 cases were included.According to the severity of the disease,it is divided into non-severe group and severe group.The collected data include the general condition,symptoms at admission,basic diseases,and first-time laboratory indexes（WBC count,NC,LC,NLR,PC,MONO,plasma CRP,plasma FIB,ESR）.SPSS25.0 and Medcalc 20.0.3were used to analyze the data,and the difference between the two groups was compared.P<0.05 was statistically significant.Results:（1）The age of patients in severe group was higher than that in non-severe group,and the difference was statistically significant（P<0.05）.The proportion of males,hypertension and diabetes in severe group was higher than that in non-severe group,and the difference was statistically significant（P<0.05）.There was no significant difference in smoking,coronary heart disease,pulmonary tuberculosis and chronic obstructive pulmonary disease between the two groups（P>0.05）.（2）The proportion of cough,fever and expectoration in severe group was higher than that in non-severe group,and the differences were statistically significant（P<0.05）.（3）WBC count,NC,NLR,plasma CRP,plasma FIB and ESR levels in severe group were higher than those in non-severe group,and the differences were statistically significant（P<0.05）.The levels of LC and PC in severe group were lower than those in non-severe group,and the differences were statistically significant（P<0.05）.There was no significant difference in the level of MONO between severe group and non-severe group（P>0.05）.（4）Multivariate logistic regression analysis showed that NLR and plasma CRP were independent risk factors for adult COVID-19 patients to become severe.（5）Draw ROC curve:The best cutoff values of NC,LC,NLR and plasma CRP for predicting the progression of adult COVID-19 to severe disease are5.11×10~9/L,0.92×10~9/L,5.30 and 47.38 mg/L,respectively;The sensitivity were 50%,81.82%,65.91%and 68.18%respectively.The specificity was 88.18%,75.45%,90%and 96.36%respectively.AUC is 0.702,0.809,0.827 and 0.894,respectively.The AUC of the combined predictor（NLR+plasma CRP）is 0.912,with a sensitivity of75.00%and a specificity of 94.55%.（6）Comparison of AUC of each single index:The AUC of plasma CRP and NLR is higher than that of NC,and the difference is statistically significant（P<0.05）,but there is no statistical difference among other indexes（P>0.05）.（7）Comparison between NLR+plasma CRP and AUC of each single index:AUC of NLR+plasma CRP is higher than NC,LC and NLR,and the differences are statistically significant（P<0.05）,Compared with the AUC of plasma CRP,there was no significant difference（P>0.05）.Conclusion:（1）Most of adult COVID-19 patients in Enshi are non-critical patients.The most common symptoms at admission are cough,fever and expectoration.Some patients have no symptoms from admission to discharge.Elderly,male,patients with hypertension and diabetes are more likely to develop into severe diseases.（2）The early stage of adult COVID-19patients with severe illness is often accompanied by the increase of plasma CRP and NLR and the decrease of LC,and these three indexes have high predictive value for the progression of adult COVID-19 patients to severe illness.（3）The increase of NLR and plasma CRP is an independent risk factor for adult COVID-19 patients to develop into severe disease.（4）Lower LC,higher NLR and plasma CRP have higher value in predicting the progression of severe cases in adult patients with covid-19.（5）The combined predictor（NLR+plasma CRP）has a very high value in predicting the progression of severe cases in adult patients with covid-19. |
PDF Full Text Request