Abstract

Background

Leukocyte differential present certain features in COVID 19 patients. RE-LYMP (reactive lymphocytes) is an extended inflammation parameter (EIP) reported by XN analyzer (Sysmex Corporation, Kobe, Japan) reflect the activation of lymphocytes triggered by infections. We aimed to assess the clinical utility of these parameters as biomarkers for the rapid detection of COVID 19.

Methods

The study group included 200 COVID 19 and 167 patients with other infections at admission. Differences of leukocyte differential, neutrophil/lymphocyte ratio (NLR) and EIP among groups were assessed with the Kruskal-Wallis test; parameters statiscally different in the groups were tested with Receiver operating characteristic (ROC) curve analysis to assess their diagnostic performance in distinguishing SARS-CoV-2 infections. The reliability of the selected parameters was evaluated in a validation group of 347 patients (160 COVID 19 and 187 other infections).

Results

NLR performed well to discard viral infections, area under curve (AUC) 0.988 (95%CI 0.973 − 0.991) and RE-LYMP was useful to distinguish COVID 19 and bacterial infections AUC 0.920 (95%CI 0.884 − 0.948); the two conditions NLR> 3.3 RE-LYMP> 0.6% was applied to the validation group and 153 out of 160 COVID 19 patients were correctly distinguished (95.6%).

Conclusions

Early diagnosis of SARS-CoV-2 infection is critical for better caring of patients and to reduce the threat of nosocomial infection for professionals. Leukocyte differential and RE-LYMPH could assist in a preliminary differential diagnosis of the disease.

中文翻译：

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Sysmex XN 分析仪在评估 SARS-CoV-2 感染中的白细胞分类和反应性淋巴细胞计数

摘要

背景

白细胞差异在 COVID 19 患者中具有某些特征。RE-LYMP（反应性淋巴细胞）是 XN 分析仪（Sysmex Corporation，Kobe，Japan）报告的扩展炎症参数（EIP），反映了感染引发的淋巴细胞活化。我们旨在评估这些参数作为快速检测 COVID 19 的生物标志物的临床效用。

方法

该研究组包括 200 名 COVID 19 和 167 名入院时患有其他感染的患者。采用Kruskal-Wallis检验评估各组白细胞分类、中性粒细胞/淋巴细胞比值（NLR）和EIP的差异；使用接受者操作特征 (ROC) 曲线分析测试组中统计学上不同的参数，以评估它们在区分 SARS-CoV-2 感染方面的诊断性能。在 347 名患者（160 名 COVID 19 和 187 名其他感染）的验证组中评估了所选参数的可靠性。

结果

NLR 在排除病毒感染方面表现良好，曲线下面积 (AUC) 0.988 (95%CI 0.973 - 0.991) 和 RE-LYMP 可用于区分 COVID 19 和细菌感染 AUC 0.920 (95%CI 0.884 - 0.948)；NLR> 3.3 RE-LYMP> 0.6% 的两个条件应用于验证组，160 名 COVID 19 患者中有 153 名被正确区分（95.6%）。

结论

SARS-CoV-2 感染的早期诊断对于更好地护理患者和减少对专业人员的医院感染威胁至关重要。白细胞鉴别和 RE-LYMPH 有助于对该疾病进行初步鉴别诊断。