入院乳酸水平与新型冠状病毒感染病情危重程度的相关性分析

Correlation Analysis between Admission Lactic Acid Level and the Severity of COVID-19

摘要: 目的：评估实验室检测指标对新型冠状病毒感染(COVID-19)患者病情危重程度的预测价值。方法：回顾性收集156例在我院就诊的COVID-19患者。根据中国新型冠状病毒肺炎诊疗指南(第十版)将患者分为非重症组(n = 100)和重症组(n = 56)。比较两组患者基线及实验室检测指标。采用多因素逻辑回归分析COVID-19患者病情危重的影响因素。采用ROC曲线评估验室检测指标的诊断价值。结果：与非重症组相比，重症组患者年龄较大，且更易合并基础疾病，但发病至入院时间较短；重症组患者白细胞计数、中性粒细胞计数、乳酸脱氢酶、肌酐、C-反应蛋白、降钙素原和白细胞介素-6、乳酸和葡萄糖水平均增高；重症组患者的血小板计数、白蛋白和氧合指数水平降低(所有P < 0.05)。多因素逻辑回归分析发现，年龄、发病至入院时间和入院时乳酸水平是COVID-19患者病情危重的独立影响因素(所有P < 0.05)。乳酸预测COVID-19感染患者病情危重最佳诊断切点为3.250 mmol/L。结论：本研究发现入院时乳酸水平升高是COVID-19患者病情危重的独立影响因素。

Abstract: Objective: To evaluate the predictive value of laboratory test indicators for the severity of COVID-19. Methods: A total of 156 patients with COVID-19 in our hospital were retrospectively collected. According to the Chinese Guidelines for the diagnosis and treatment of COVID-19 (10th edition), the patients were divided into non-severe group (n = 100) and severe group (n = 56). The baseline and laboratory test indexes were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors of critical condition of COVID-19 patients. ROC curve was used to evaluate the diagnostic value of laboratory detection indicators. Results: Compared with the non-severe group, the patients in the severe group were older and more likely to have underlying diseases, but the time from onset to admission was shorter. The white blood cell count, neutrophil count, lactate dehydrogenase, creatinine, C-reactive protein, procalcitonin and interleukin-6 levels, lactic acid and glucose levels increased in the severe group. The levels of platelet count, albumin and oxygenation index were lower in the severe group (all P < 0.05). Multivariate logistic regression analysis showed that age, time from onset to admission, and lactic acid on admission were independent influencing factors for the critical condition of COVID-19 patients (all P < 0.05). Lactic acid predicts COVID-19 infected patients in a critical condition for best diagnostic point of tangency tendency for 3.250 mmol/L. Conclusion: This study found that the increase of lactate level on admission was an independent factor influencing the severity of COVID-19 patients.