COVID-19居家隔离患者感染早期的血象变化

Changes of Haematologic indices of COVID-19 Patients in Home Isolation at the Early Stage of Infection

目的观察新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者感染早期的血象变化特点。方法回顾分析2020-01-20/2020-02-02日作者医院门诊确诊且在1周内复诊的78例COVID-19病例,依据肺部病灶变化将其分为病情进展组(n=42)和病情好转组(n=36),以观察COVID-19自然病程状态下患者外周血象变化规律。结果78例COVID-19患者平均年龄为50岁(50±14),女性偏多(48/78),首发症状中发热54例,多为中低热(37.9±0.7℃),咳嗽24例,无症状2例。病情进展组患者复诊时血生化指标中C-反应蛋白(C-reactive protein,CRP)、白细胞(white blood cell,WBC)和中性粒细胞(neutrophils,NEU)显著升高,淋巴细胞(lymphocyte,LYM)和血小板(platelet,PLT)数则明显下降,同时NEU与LYM比值(neutrophil-to-lymphocyte ratio,NLR)在复诊时明显升高。病情好转组患者复诊CRP、LYM、PLT亦可显著恢复,但NLR值在病程中无显著变化。结论COVID-19早期病程(进展/好转)时CRP、LYM数和PLT数均有显著的变化,对预测COVID-19自然病程有一定的指导意义,但具体临床价值还有待更大样本的临床病例验证。

Objective To analyze the characteristics of haematologic indices in coronavirus disease 2019(COVID-19)pneumonia at the early stage of infection.Methods A total of 78 cases of COVID-19 confirmed in author’s hospital outpatient clinic from January 20,2020 to February 2,2020 and revisited within 1 week were retrospectively analyzed.According to the changes of lung lesions,disease progression group(n=42)and disease improvement group(n=36)to observe the changes of haematologic indices under the natural course of COVID-19.Results The average age of the 78 COVID-19 patients was 50(50±14)years old,with more females(48/78).There were 54 cases of fever in the first symptoms(mainly low and moderate fever),24 cases of cough,and 2 case of asymptomatic.The haematologic indices of C-reactive protein(CRP),white blood cells(WBC)and neutrophils(NEU)were significantly increased in patients in the progression group,while the number of lymphocytes(LYM)and platelets(PLT)were significantly decreased,the neutrophil-to-lymphocyte ratio(NLR)increased significantly at the revisit.The CRP,LYM,and PLT of the patients in the improved group could also recover significantly at the revisit,but the NLR value did not change significantly during the course of the disease.Conclusion The number of CRP,LYM and PLT changes significantly during the early course of COVID-19,which has certain guiding significance for predicting the natural course of COVID-19,but the specific clinical value needs to be verified by a larger sample of clinical cases.