486例COVID-19普通型患者血常规参数结果分析

Analysis of blood routine parameters in 486 patients with common type of COVID-19

目的分析2019新型冠状病毒肺炎(COVID-19)普通型患者血常规参数结果,为临床早期辅助诊断提供依据。方法收集2020年2-3月鄂州市第三医院和鄂州市雷山医院收治的486例确诊为COVID-19普通型患者(男255例,女231例)纳入患者组,收集COVID-19普通型患者的临床资料及入院时首次血常规结果,门诊体检健康者(核酸检测阴性,非COVID-19)271例(男140例,女131例)纳入对照组。对男女患者排除基础疾病前后结果,以及与对照者分别进行比较,差异有统计学意义(P<0.05)的参数进行受试者工作特征(ROC)曲线分析。结果男女COVID-19普通型患者与对照者比较,各有14个参数差异有统计学意义(P<0.05),其中男性患者C反应蛋白(CRP)和中性粒细胞百分比(NEUT%)明显偏高,白细胞计数(WBC)、淋巴细胞百分比(LYMPH%)、淋巴细胞计数(LYMPH#)、嗜酸性粒细胞百分比(EO%)、嗜酸性粒细胞计数(EO#)、红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(Hct)、红细胞平均血红蛋白量(MCH)明显偏低;女性患者CRP和红细胞体积分布宽度变异系数(RDW-CV)明显偏高,WBC、LYMPH%、LYMPH#、RBC、Hb、Hct明显偏低;排除基础疾病前后各指标分别在男女患者中比较,差异无统计学意义(P>0.05);ROC曲线分析显示,男性患者NUET%、LYMPH%、LYMPH#、EO%、RBC、Hb、Hct、CRP及女性LYMPH#、RBC、Hb、Hct、CRP的ROC曲线下面积(AUC)>0.700。结论COVID-19普通型患者血常规参数中除WBC和LYMPH#降低、CRP升高外,男女患者均存在RBC、Hb、Hct的降低,男性患者的NEUT%升高,LYMPH%和EO%降低也具有一定的早期辅助诊断价值。

Objective To investigate blood routine parameters of common type coronavirus disease 2019(COVID-19)patients,and provide a basis for early clinical diagnosis.Methods Clinical data and results of the first time blood routine of 486 patients(patients group,255 males and 231 females)with common type of COVID-19 who presented to Ezhou Third People′s Hospital and Leishan Hospital in Ezhou from February to March 2020 were collected.A total of 271 physical examiners(140 males and 131 females)with negative nucleic acid test(non COVID-19)were enrolled in control group.The results before and after excluding basic diseases were compared.The results of patients group were compared with those in control group.Receiver operating characteristic(ROC)curve analysis was performed for parameters with statistical significance(P<0.05).Results Compared with those in control group,there were significant differences on 14 parameters both in male and female patients(P<0.05).Among male patients,C-reactive protein(CRP)and neutrophil percentage(NEUT%)were significantly higher,and white blood cell count(WBC),lymphocyte percentage(LYMPH%),lymphocyte count(LYMPH#),eosinophil percentage(EO%),eosinophil count(EO#),red blood count(RBC),hemoglobin(Hb),RBC hematocrit(Hct),RBC average amount of hemoglobin(MCH)were significantly lower than those of male controls.Among female patients,CRP and coefficient of variation in the width of erythrocyte volume distribution(RDW-CV)were significantly higher,WBC,LYMPH%,LYMPH#,RBC,Hb,Hct were significantly lower than those of female controls.There was no significant difference before and after excluding basic diseases both in male patients and female patients(P>0.05).ROC curve analysis showed that AUC of NUET%,LYMPH%,LYMPH#,EO%,RBC,Hb,Hct,CRP in male patients and LYMPH#,RBC,Hb,Hct,CRP in female patients were higher than 0.700.Conclusion In addition to the decrease of WBC and LYMPH%and the increase of CRP,RBC,Hb,Hct decreased in both male and female common type of COVID-19 patients.The increase of NEUT%,the decrease of LYMPH%and EO%in male patients also have a certain value of early auxiliary diagnosis.