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Chang Q, Li Y, Xue M, Yu C, He J, Duan X. Serum amyloid A is a potential predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis. Front Neurol 2023; 14:1219604. [PMID: 37483455 PMCID: PMC10359907 DOI: 10.3389/fneur.2023.1219604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives Inflammation shows a notable relationship to acute ischemic stroke's (AIS) occurrence and prognosis. However, existing research has confirmed that serum amyloid A (SAA) is an inflammatory biomarker. The aim of this paper was to investigate the association between SAA and the three-month clinical results of acute AIS patients after intravenous thrombolysis (IVT). Methods The evaluation of AIS patients with complete medical records was carried out by prospectively investigating patients hospitalized in our department between January 2020 and February 2023. The SAA levels were examined with the use of an immunosorbent assay kit that shows a relationship with the enzyme (Invitrogen Corp). Patients were dichotomized into favorable (mRS score of 0, 1 or 2) and unfavorable (mRS score of 3, 4, 5, or 6) results with the use of the modified Rankin Scale (mRS). Results A total of 405 AIS patients who were subjected to IVT therapy were prospectively covered. To be specific, 121 (29.88%) patients had an unfavorable prognosis during the follow-up for 3 months. On that basis, patients achieving unfavorable results gained notably greater SAA levels (39.77 (IQR 38.32-46.23) vs.31.23 (IQR 27.44-34.47), p < 0.001) during hospitalization in comparison to patients with a better result. In the analysis with multiple variates, SAA was adopted to achieve the independent prediction of the three-month unfavorable clinical results of acute AIS patients after IVT [OR:2.874 (95% CI, 1.764-4.321), p < 0.001]. When the fundamental confounding factors were regulated, the odds ratio (OR) of unfavorable prognosis after AIS patients undergoing IVT therapy was 4.127 (95% CI = 1.695-10.464, p = 0.032) for the maximum tertile of SAA in terms of the minimal tertile. With an AUC of 0.703 (95% CI, 0.649-0.757), SAA revealed a notably more effective discriminating capability in terms of CRP, NLR, EMR, and WBC. SAA as a predictor in terms of the prediction of three-month unfavorable results after AIS patients undergoing IVT therapy achieved specificity and sensitivity of 84.45% and 77.23%, as well as an optimal cut-off value (COV) of 37.39. Conclusion SAA level that is up-regulated during hospitalization is capable of serving as an effective marker in terms of the prediction of unfavorable three-month results in AIS patients after IVT.
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Affiliation(s)
- Qi Chang
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
| | - Yaqiang Li
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
- Department of Neurology, People’s Hospital of Lixin County, Bozhou, China
| | - Min Xue
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
| | - Chuanqing Yu
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
| | - Jiale He
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
| | - Xun Duan
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People’s Hospital of Huainan), Huainan, China
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Zhai M, Yang J, Cao X, Li Y, Xu H, Wang Y. Determinants of 1-Year Unfavorable Outcomes of Intravenous Alteplase Thrombolysis for Acute Ischemic Stroke. Clin Appl Thromb Hemost 2023; 29:10760296231187616. [PMID: 37461226 DOI: 10.1177/10760296231187616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Intravenous thrombolytic therapy has become the standard of treatment for eligible patients with ischemic stroke. However, outcomes after receiving intravenous thrombolytic therapy vary widely. This study aims to investigate determinants of 1-year clinical outcomes of intravenous thrombolytic therapy for patients with acute ischemic stroke. METHODS In a prospective, observational study, patients with acute ischemic stroke treated with intravenous thrombolysis were consecutively included, and clinical information and laboratory data were collected. The patients were followed up for 12 months after onset, and the 1-year clinical outcome was evaluated using modified Rankin Scale scores. A score ≥ 3 was defined as unfavorable functional outcome. Univariate and multivariate logistic regressions were used to assess the determinants of the 1-year clinical outcomes of intravenous thrombolysis for acute ischemic stroke. RESULTS A total of 222 patients with intravenous thrombolysis were enrolled, and we identified 58 patients (26.1%) had unfavorable functional outcomes. Multivariate logistic regression analysis revealed that mean platelet volume-to-lymphocyte ratio (MPVLR) (odds ratio [OR] = 1.114, 95% confidence interval [CI]: 1.024-1.211, P = .012), atrial fibrillation (OR = 2.553, 95% CI: 1.086-6.002, P = .032), symptomatic stenosis occlusion (OR = 2.547, 95% CI: 1.269-5.110, P = .009), and baseline National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.141, 95% CI: 1.074-1.212, P < .001) were independent predictors of unfavorable functional outcomes at 1 year. CONCLUSIONS In patients receiving intravenous thrombolysis, we found that MPVLR, atrial fibrillation, symptomatic stenosis occlusion, and baseline NIHSS score were significant predictors of unfavorable functional outcomes at 1 year.
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Affiliation(s)
- Mingfeng Zhai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Neurology, The Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
| | - Jinwei Yang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoyan Cao
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, China
- Anhui Public Health Clinical Center, Hefei, China
| | - Yingying Li
- Department of Neurology, The Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
| | - Hui Xu
- Department of Neurology, The Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
| | - Yu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Niu MH, Liu PH, Liu ZH, Zhu JW, Guo R, He F. The relationship between mean platelet volume lymphocyte ratio and collateral circulation in patients with chronic total coronary occlusion. Front Cardiovasc Med 2022; 9:1008212. [DOI: 10.3389/fcvm.2022.1008212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo correlate mean platelet volume lymphocyte ratio (MPVLR) and coronary collateral circulation (CCC) in patients with chronic total occlusion (CTO).Materials and methodsA total of 643 patients who were hospitalized at a single large academic medical center from January 2020 to October 2021 and had CTO lesions in at least one major coronary artery confirmed by coronary angiography were retrospectively analyzed. Patients were divided according to the Rentrop criteria into poorly formed CCC (Rentrop grade 0–1, n = 235) and well-formed CCC (Rentrop grade 2–3, n = 408) groups. Mean platelet volume lymphocyte ratio (MPVLR) was calculated from routine laboratory data (MPV divided by lymphocyte count). The clinical data of the two groups were compared, and relationships between MPVLR and CCC formation were analyzed.ResultsThe MPVLR of patients with poorly formed CCC was significantly higher than that of patients with well-formed CCC (7.82 ± 3.80 vs. 4.84 ± 1.42, P < 0.01). The prevalence of diabetes mellitus and C-reactive protein levels were significantly higher in the poor CCC group than in the good CCC group (P < 0.01), while the proportions of patients with CTO or multivessel lesions in the right coronary artery were significantly lower in the poor CCC group than in the good CCC group (P < 0.01). Multivariate logistic regression analysis identified MPVLR (OR: 2.101, 95% CI: 1.840–2.399, P < 0.01), C-reactive protein level (OR: 1.036, 95% CI: 1.008–1.064, P < 0.05), a history of diabetes mellitus (OR: 2.355, 95% CI: 1.532–3.621, P < 0.01), and right coronary CTO ratio (OR: 0.313, 95% CI: 0.202–0.485, P < 0.01) as independent risk factors for CCC formation. The area under the ROC curve of MPVLR for predicting poorly formed CCC was 0.82 (95% CI: 0.784–0.855, P < 0.01), the best cut-off point was 6.02 and the sensitivity and specificity of MPVLR for predicting poorly formed CCC were 72.3 and 82.4%, respectively.ConclusionIn patients with coronary CTO, MPVLR was negatively correlated with CCC and a high MPVLR level was an independent predictor of poorly formed CCC.
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Zhang Y, Wang J, Ma Z, Mu G, Liang D, Li Y, Qian X, Zhang L, Shen F, Zhang L, Yu J, Liu Y. Prospective pilot study of tirofiban in progressive stroke after intravenous thrombolysis. Front Neurol 2022; 13:982684. [PMID: 36267890 PMCID: PMC9577296 DOI: 10.3389/fneur.2022.982684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Intravenous thrombolysis (IVT) is a standard procedure for the treatment of patients with acute ischemic stroke (AIS). Improving the therapeutic efficacy of IVT is an important task for neurologists. The aim of this study was to evaluate the efficacy and safety of early low-dose tirofiban treatment in AIS patients with early neurological deterioration (END) after IVT. Methods In this prospective and randomized pilot study, 73 AIS patients with END were recruited from a local hospital in China. Of these, 14 patients were treated with regular antiplatelet agents (aspirin plus clopidogrel) and 59 patients were treated with tirofiban within 24 h of IVT, followed by regular antiplatelet therapy. Neurological deficits and functional recovery were assessed with NIHSS and modified Rankin Scale (mRS) at 7 and 90 days. During the 90-day follow-up period, both hemorrhagic (e.g., intracerebral hemorrhage) and non-hemorrhagic (e.g., pneumonia) events were recorded. Results Treatment with tirofiban compared with regular antiplatelet therapy: (1) improved functional recovery of AIS patients to mRS (≤2) at both 7 and 90 days (odds ratios [ORs], 1.37 and 1.64; 95% confidence interval [CI], 1.16–1.61 and 1.26–2.12; P = 0.008 and < 0.001, respectively), and (2) reduced NIHSS scores from 11.14 ± 2.38 to 5.95 ± 3.48 at day 7 (P < 0.001) and from 8.14 ± 2.74 to 4.08 ± 3.50 at day 90 (P < 0.001). Tirofiban treatment did not increase the risk of hemorrhagic complications. Multivariate regression analysis showed that tirofiban treatment independently predicted a favorable functional outcome (P ≤ 0.001). Conclusion Early treatment with low-dose tirofiban in AIS patients with neurologic deterioration after IVT potentially improved functional recovery and attenuated neurologic deficits as early as 7 days and did not increase the risk of various hemorrhagic complications. However, the therapeutic efficacy of tirofiban treatment in END patients needs to be determined by future randomized clinical trials with a large study population. Clinical trial registration http://www.chictr.org.cn/, Identifier ChiCTR2200058513.
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Affiliation(s)
- Yan Zhang
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
- *Correspondence: Yan Zhang
| | - Jianliang Wang
- Department of Radiology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Zhaoxi Ma
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Guihua Mu
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Da Liang
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Yifan Li
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Xiaoyan Qian
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Luyuan Zhang
- Department of Scientific and Technological Talents, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Fang Shen
- Department of Outpatient, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Lei Zhang
- Department of Neurology, The Kunshan Affiliated Hospital of Jiangsu University, The First People's Hospital of Kunshan, Kunshan, China
| | - Jie Yu
- Department of Neurology, The Second People's Hospital of Kunshan, Kunshan, China
| | - Yang Liu
- Department of Neurology, Saarland University, Homburg, Germany
- Yang Liu
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Sharma D, Bhaskar SMM. Prognostic Role of the Platelet-Lymphocyte Ratio in Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy: A Meta-Analysis. J Cent Nerv Syst Dis 2022; 14:11795735221110373. [PMID: 35860715 PMCID: PMC9290168 DOI: 10.1177/11795735221110373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Both inflammation and thrombotic/hemostatic mechanisms may play a role in acute ischemic stroke (AIS) pathogenesis, and a biomarker, such as the platelet-to-lymphocyte ratio (PLR), considering both mechanisms may be of clinical utility. Objectives This meta-analysis sought to examine the effect of PLR on functional outcomes, early neurological changes, bleeding complications, mortality, and adverse outcomes in AIS patients treated with reperfusion therapy (RT). Design Systematic Review and Meta-Analysis Data Sources and Methods Individual studies were retrieved from the PubMed/Medline, EMBASE and Cochrane databases. References thereof were also consulted. Data were extracted using a standardised data sheet, and systematic reviews and meta-analyses on the association of admission (pre-RT) or delayed (post-RT) PLR with defined clinical and safety outcomes were conducted. In the case of multiple delayed PLR timepoints, the timepoint closest to 24 hours was selected. Results Eighteen studies (n=4878) were identified for the systematic review, of which 14 (n=4413) were included in the meta-analyses. PLR collected at admission was significantly negatively associated with 90-day good functional outcomes (SMD=−.32; 95% CI = −.58 to −.05; P=.020; z=−2.328), as was PLR collected at delayed timepoints (SMD=−.43; 95% CI = −.54 to −.32; P<.0001; z=−7.454). PLR at delayed timepoints was also significantly negatively associated with ENI (SMD=−.18; 95% CI = −.29 to −.08; P=.001. Conversely, the study suggested that a higher PLR at delayed timepoints may be associated with radiological bleeding and mortality. The results varied based on the type of RT administered. Conclusions A higher PLR is associated with worse outcomes after stroke in terms of morbidity, mortality, and safety outcomes after stroke.
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Affiliation(s)
- Divyansh Sharma
- Global Health Neurology and Translational Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,University of New South Wales (UNSW), South Western Sydney Clinical School, Sydney, NSW, Australia
| | - Sonu M M Bhaskar
- Global Health Neurology and Translational Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.,University of New South Wales (UNSW), South Western Sydney Clinical School, Sydney, NSW, Australia.,Department of Neurology & Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District (SWSLHD), Sydney, NSW, Australia.,NSW Brain Clot Bank, NSW Health Pathology, NSW, Sydney, Australia
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Zheng YY, Wang L, Shi Q. Mean platelet volume (MPV) and platelet distribution width (PDW) predict clinical outcome of acute ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci 2022; 101:221-227. [DOI: 10.1016/j.jocn.2022.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
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Shen CL, Xia NG, Wang H, Zhang WL. Association of Stress Hyperglycemia Ratio With Acute Ischemic Stroke Outcomes Post-thrombolysis. Front Neurol 2022; 12:785428. [PMID: 35095730 PMCID: PMC8793935 DOI: 10.3389/fneur.2021.785428] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Purpose: The association between stress hyperglycemia and clinical outcomes in patients with acute ischemic stroke treated with intravenous thrombolysis (IVT) is uncertain. We sought to analyze the association between the stress hyperglycemia ratio (SHR) using different definitions and clinical outcomes in acute patients with ischemic stroke undergoing IVT. Methods: A total of 341 patients with ischemic stroke receiving IVT were prospectively enrolled in this study. The SHR was evaluated using different equations: SHR1, fasting glucose (mmol/L)/glycated hemoglobin (HbA1c) (%); SHR2, fasting glucose (mmol/L)/[(1.59 × HbA1c)−2.59]; SHR3, admission blood glucose (mmol/L)/[(1.59 × HbA1c)−2.59]. A poor functional outcome was defined as a modified Rankin scale score of 3–6 at 3 months. Multivariate logistic regression analysis was used to identify the relationship between different SHRs and clinical outcomes after IVT. Results: A total of 127 (37.2%) patients presented with poor functional outcomes at 3 months. The predictive value of SHR1 for poor functional outcomes was better than that of SHR2 and SHR3 in receiver operating characteristic analyses. On multivariate analysis, SHR1 [odds ratio (OR) 14.639, 95% CI, 4.075–52.589; P = 0.000] and SHR2 (OR, 19.700; 95% CI; 4.475–86.722; P = 0.000) were independently associated with an increased risk of poor functional outcome but not SHR3. Conclusions: Our study confirmed that the SHR, as measured by SHR1 and SHR2, is independently associated with worse clinical outcomes in patients with ischemic stroke after intravenous thrombolysis. Furthermore, SHR1 has a better predictive performance for outcomes than other SHR definitions.
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Affiliation(s)
- Chuan-Li Shen
- Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Nian-Ge Xia
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wan-Li Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Yun S, Jun Yi H, Hoon Lee D, Hoon Sung J. Clinical significance of platelet to neutrophil ratio and platelet to lymphocyte ratio in patients with aneurysmal subarachnoid hemorrhage. J Clin Neurosci 2021; 92:49-54. [PMID: 34509261 DOI: 10.1016/j.jocn.2021.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/21/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022]
Abstract
The aim of study was aimed to investigate associations of platelet-to-neutrophil ratio (PNR) and platelet-to-lymphocyte ratio (PLR) on admission with clinical outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). A retrospective analysis was performed on patients who were treated for aSAH. Unfavorable clinical outcome was defined as Modified Rankin Scale (mRS) score of 3-6 at 90-days. Receiver operating characteristic curve analysis was performed to detect optimal cutoff values of PNR and PLR for predicting clinical outcomes. Logistic regression was used to explore associations of PNR and PLR with clinical outcomes. A total of 544 patients with aSAH were enrolled. Of them, 152 (29.9%) had unfavorable clinical outcome. Optimal cutoff values of PNR and PLR to predict clinical outcomes at 90 days after aSAH were 25 and 130, respectively (P < 0.001 and <0.001, respectively). In multivariate logistic regression analysis, PNR <25 and PLR ≥ 130 were associated with unfavorable clinical outcome at 90 days after aSAH (odds ratio [OR]: 1.81; 95% confidence interval [CI]: 1.23-3.69; P = 0.018 and OR: 1.56; 95% CI: 1.18-2.62; P = 0.031, respectively). PNR and PLR as novel inflammatory biomarkers could predict the clinical outcome after aSAH. PNR <22 and PLR ≥ 130 were associated with unfavorable clinical outcome at 90 days after aSAH.
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Affiliation(s)
- Seonyong Yun
- Department of Neurosurgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea; Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Jun Yi
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea; Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Dong Hoon Lee
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae Hoon Sung
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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The importance of mean platelet volume to lymphocyte ratio in predicting atrial fibrillation after coronary bypass operations. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.957145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wang H, Xing Y, Yao X, Li Y, Huang J, Tang J, Zhu S, Zhang Y, Xiao J. Retrospective Study of Clinical Features of COVID-19 in Inpatients and Their Association with Disease Severity. Med Sci Monit 2020; 26:e927674. [PMID: 33342993 PMCID: PMC7760720 DOI: 10.12659/msm.927674] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study was to analyze the clinical features and laboratory indices of patients with coronavirus disease (COVID-19) and explore their association with the severity of the disease. MATERIAL AND METHODS A total of 61 patients with COVID-19 were divided into groups with common symptoms and with severe diseases, and clinical data were collected to analyze and compare the differences between them. RESULTS In patients with severe COVID-19, compared with the common group, lymphocyte count and albumin levels were lower, and aspartate aminotransferase (AST), blood urea, blood creatinine, lactate dehydrogenase (LDH), and C-reactive protein (CRP) levels, and prothrombin time (PT) were elevated (all P<0.05). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and C-reactive protein-to-albumin ratio (CAR) were significantly elevated in the severe group compared with the group with common symptoms; however, the lymphocyte-to-monocyte ratio (LMR) was significantly reduced (P<0.05). Univariate logistic regression showed that lower lymphocyte count, prolonged PT, elevated CRP and LDH levels, and elevated NLR, PLR, MPVLR, and CAR were risk factors for COVID-19 severity (P<0.05). Multivariate logistic regression showed that elevated CRP levels (odds ratio [OR], 0.028; 95% confidence interval [CI]: 0.002-0.526; P=0.017), prolonged PT (OR, 0.014; 95% CI: 0.001-0.341; P=0.09), and an MPVLR >8.9 (OR, 0.026; 95% CI: 0.002-0.349; P=0.006) were independent risk factors for COVID-19 severity. CONCLUSIONS Elevated CRP and prolonged PT, and an MPVLR >8.9 were independent risk factors for COVID-19 severity.
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Affiliation(s)
- Hao Wang
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Yang Xing
- Department of Clinical Laboratory, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Xiaohong Yao
- Department of Medical Section, Traditional Chinese Medical Hospital of Dawu County, Xiaogan, Hubei, P.R. China
| | - Yang Li
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Jietao Huang
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Jun Tang
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Shasha Zhu
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Ying Zhang
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
| | - Jun Xiao
- Department of Cardiovascular Medicine, Chongqing University Center Hospital, Chongqing, P.R. China
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