D-二聚体对新型冠状病毒奥密克戎变异株感染者发展重症风险的预测价值

Prediction value of D-dimer on the risk of developing severe disease in patients with severe acute respiratory syndrome coronavirus 2 Omicron variant

目的探讨新型冠状病毒(SARS-CoV-2)奥密克戎变异株感染者入院时D-二聚体水平对其发展重症风险的预测价值。方法回顾性分析该院2022年4-6月入院时为非重症型的奥密克戎变异株感染者294例,按照住院期间的疾病发展分为非重症组252例和重症组42例。检测入院时D-二聚体与相关感染生物标志物水平,采用二元Logistic回归分析奥密克戎变异株感染者发展为重症的影响因素,绘制受试者工作特征曲线分析相关指标对感染奥密克戎变异株的非重症患者疾病发展为重症的预测效能。结果入院时D-二聚体水平和中性粒细胞百分比是奥密克戎变异株感染者疾病发展为重症的影响因素(OR=2.600,95%CI:1.494~4.527,P=0.001;OR=1.087,95%CI:1.031~1.145,P=0.002)。D-二聚体预测奥密克戎变异株感染者发展为重症的曲线下面积(AUC)为0.856(95%CI:0.793~0.919),中性粒细胞百分比预测奥密克戎变异株感染者发展为重症的AUC为0.809(95%CI:0.736~0.881),2项指标联合预测的AUC为0.872(95%CI:0.808~0.930)。结论感染奥密克戎变异株后,D-二聚体水平与中性粒细胞百分比可有效预测奥密克戎变异株感染者发展为重症的风险。

Objective To explore the predictive value of D-dimers level on the risk of developing severe disease in patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron variant.Methods A total of 294 patients with Omicron variant infection in this hospital from April to June 2022 were retrospectively analyzed.According to the disease development during hospitalization,they were divided into the non-severe group(252 cases)and the severe group(42 cases).The levels of D-dimer and related infection biomarkers at admission were measured.Binary Logistic regression analysis was used to analyze the influencing factors of developing severe disease in Omicron variant infected patients,and the receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of each indicator in the development of severe disease in non-severe patients infected with Omicron variants.Results The level of D-dimer and the percentage of neutrophils at admission were the influencing factors of developing severe disease in patients with Omicron variant infection(OR=2.600,95%CI:1.494-4.527,P=0.001;OR=1.087,95%CI:1.031-1.145,P=0.002).The area under the curve(AUC)of D-dimer for predicting the development of severe disease in patients with Omicron variant was 0.856(95%CI:0.793-0.919).The AUC of neutrophil percentage in predicting the development of severe disease in patients with Omicron variant was 0.809(95%CI:0.736-0.881).The AUC of the combined prediction of the two indicators was 0.872(95%CI:0.808-0.930).Conclusion After infection with Omicron variant,the level of D-dimer and the percentage of neutrophils can effectively predict the risk of developing severe disease in patients with Omicron variant.