Abstract

Coronavirus Disease 2019 is a very fast-spreading infectious disease. Severe forms are marked by a high mortality rate. The objective of this study is to identify routine biomarkers that can serve as early predictors of the disease progression. This is a prospective, single-center, cohort study involving 330 SARS-CoV-2 infected patients who were admitted at the University Hospital of Blida, Algeria in the period between the 27th of March and 22nd of April 2020. The ROC curve was used to evaluate the predictive performance of biomarkers, assessed at admission, in the early warning of progression toward severity. Multivariate logistic regression was used to quantify the independent risk for each marker. After an average follow-up period of 13.9 ± 3.5 days, 143 patients (43.3%) were classified as severe cases. Six biological abnormalities were identified as potential risk markers independently related to the severity: elevated urea nitrogen (>8.0 mmol/L, OR = 9.3 [2.7–31.7], p < .00001), elevated CRP (>42mg/L, OR = 7.5 [2.4–23.3], p = .001), decreased natremia (<133. 6 mmol/L, OR = 6.0 [2.0–17.4], p = .001), decreased albumin (<33.5 g/L, OR = 5.2 [1.7–16.6], p = .003), elevated LDH (>367 IU/L, OR = 4.9 [1.7–14.2], p = .003) and elevated neutrophil to lymphocyte ratio (>7.99, OR = 4.2, [1.4–12.2], p = .009). These easy-to-measure, time-saving and very low-cost parameters have been shown to be effective in the early prediction of the COVID-19 severity. Their use at the early admission stage can improve the risk stratification and management of medical care resources in order to reduce the mortality rate.

摘要

冠状病毒病2019是一种非常快速传播的传染病。严重的形式以高死亡率为特征。这项研究的目的是确定可以作为疾病进展的早期预测指标的常规生物标志物。这是一项前瞻性，单中心，队列研究，涉及330名SARS-CoV-2感染患者，这些患者于2020年3月27日至4月22日之间在阿尔及利亚的布利达大学医院接受了治疗。使用了ROC曲线。在进入严重程度的早期预警中，评估在入院时评估的生物标志物的预测性能。多元逻辑回归用于量化每个指标的独立风险。在平均13.9±3.5天的随访期后，将143例患者（43.3％）归为严重病例。p  <.00001），CRP升高（> 42mg / L，或= 7.5 [2.4–23.3]，p  = .001），血钠降低（<133。6 mmol / L，或= 6.0 [2.0–17.4]，p  = .001），白蛋白降低（<33.5 g / L，OR = 5.2 [1.7-16.6]，p  = .003），LDH升高（> 367 IU / L，OR = 4.9 [1.7-14.2]，p  =。 003），嗜中性白细胞与淋巴细胞的比例升高（> 7.99，OR = 4.2，[1.4-12.2]，p  = .009 ）。这些易于测量，节省时间和成本非常低的参数已被证明对COVID-19严重性的早期预测有效。在早期入院阶段使用它们可以改善风险分层和医疗资源的管理，以降低死亡率。