普通型新型冠状病毒肺炎与甲型及乙型流感病毒感染患者的血常规分析

An analysis of blood routine examination in patients with moderate COVID-19,influenza A and influenza B infection

目的探讨血常规参数对鉴别普通型新型冠状病毒肺炎(COVID-19)与甲型及乙型流感病毒感染患者的诊断价值。方法回顾性分析42例普通型COVID-19患者(A组)、63例甲型流感病毒感染患者(B组)及34例乙型流感病毒感染患者(C组)首次入院时的血常规检测结果。比较各组血常规主要参数的差异,分析血常规参数对普通型COVID-19筛查的诊断价值。结果与A组相比,B组和C组淋巴细胞百分比和红细胞分布宽度标准差差异有统计学意义(P<0.05或P<0.01);B组与C组白细胞计数、中性粒细胞百分比、淋巴细胞百分比和红细胞分布宽度标准差差异均有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,淋巴细胞百分比和红细胞分布宽度标准差与普通型COVID-19发生密切相关(P<0.01)。ROC曲线分析显示,淋巴细胞百分比和红细胞分布宽度标准差整合参数AUC达0.859[95%CI(0.790~0.928)],当取诊断界值为0.240时,鉴别普通型COVID-19患者与非COVID-19患者的灵敏度、特异度、阳性预测值和阴性预测值分别为83.33%、73.20%、57.38%和91.03%。结论淋巴细胞百分比和红细胞分布宽度标准差对于鉴别诊断普通型COVID-19与甲型及乙型流感病毒感染具有重要参考价值。

Objective To investigate the diagnostic value of blood routine indexes in differentiating the patients with moderate coronavirus disease 2019(COVID-19) from those with influenza A and influenza B infection.Methods The data of blood routine indexes after hospitalization in 42 patients with moderate COVID-19(group A),63 cases with influenza A(group B) and 34 cases with influenza B(group C) were retrospectively analyzed.The differences of blood routine indexes were compared among three groups.The diagnostic value of blood routine indexes in screening moderate COVID-19 was evaluated.Results Compared with group A,the lymphocyte percentage and red blood cell distribution width-standard deviation(RDW-SD) in groups of B and C were significantly different(P<0.05 or P<0.01).There were statistical differences in the white blood cell count,neutrophil percentage,lymphocyte percentage and RDW-SD between groups of B and C(P<0.05 or P<0.01).The logistic regression analysis showed that the lymphocyte percentage and RDW-SD were closely related with the development of moderate COVID-19(P<0.01).ROC curve analysis represented that the AUC for the combination of lymphocyte percentage and RDW-SD reached 0.859[95%CI(0.790-0.928)].When the cut-off value was 0.240,the sensitivity,specificity,positive predictive value and negative predictive value for differentiating moderate COVID-19 from non-COVID-19 were 83.33%,73.20%,57.38% and 91.03%,respectively.Conclusion The combination of lymphocyte percentage and RDW-SD could be useful in differentiating moderate COVID-19 from influenza A and influenza B.