Early predictors of the severity of COVID-19 in patients with autoinflammatory diseases

doi:10.11958/20231029

Abstract

Abstract:

Objective To investigate the value of blood cell ratio and inflammation index in predicting the severity of autoinflammatory disease (AIDs) complicated by corona virus disease 2019 (COVID-19). Methods Based on the severity of COVID-19, 148 patients with AIDs combined with COVID-19 were categorized into two groups: the mild case group (n=100) and the severe case group (n=48). Laboratory indicators, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), systemic immune-inflammation index (SII) and white blood cell to C-reactive protein ratio (LeCR), were compared between the two groups within 24 to 72 h after infection. Logistic regression was used to analyze risk factors for the severity of AIDs patients with COVID-19. Receiver operating characteristic (ROC) curves were used to assess the predictive value of indicators for the severity of AIDs and COVID-19. Results ESR, CRP, platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-lymphocyte ratio (CLR), C-reactive protein-to-albumin ratio (CAR), SII and platelet-to-albumin ratio (PAR) were higher in the severe case group than those in the mild case group. The mean platelet volume (MPV), lymphocyte count (LYM), albumin count (Alb) and LeCR levels were lower in the severe case group than those in the severe case group (P < 0.05). Logistic regression analysis indicated that elevated levels of ESR was an independent risk factor for the severity of COVID-19 in patients with AIDs, while increased levels of LeCR and SII acted as protective factors. ROC curve analysis demonstrated that LeCR was better than ESR and SII in predicting the severe of COVID-19 in AIDs patients. Conclusion ESR, SII and LeCR are effective indicators for predicting the severity of disease associated with AIDs and COVID-19.

Key words: autoinflammatory diseases, COVID-19, prognosis, leucocyte-to-C-reactive protein ratio

CLC Number:

R593.2

Figures/Tables 6

References 24

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组别			n	男性		年龄/岁		ESR/（mm/1 h）		CRP/（mg/L）		WBC/（×10⁹/L）		PLT/（×10⁹/L）		MPV/fL
轻症组			100	44（29.7）		40.4±13.7		14.50（5.00，20.53）		2.29（0.47，9.40）		7.10（5.69，8.27）		244.50（223.25，277.75）		9.70（9.00，10.74）
重症组			48	29（19.6）		43.1±15.7		23.75（14.25，53.75）		11.34（5.88，51.11）		6.25（5.50，7.30）		272.50（237.00，331.50）		9.50（8.75，10.00）
χ²、t或Z				0.061		1.079		4.575^＊		5.497^＊		1.846		2.280^＊		2.058^＊
组别	Hb/（g/L）						MON/（×10⁹/L）		LYM/（×10⁹/L）		NEU/（×10⁹/L）		SII		PLR
轻症组	131.50（121.25，144.50）						0.46（0.38，0.60）		1.85（1.56，2.34）		4.38（2.97，5.46）		533.79（356.49，789.81）		137.49（100.38，170.33）
重症组	130.00（120.00，142.00）						0.46（0.37，0.57）		1.67（1.14，2.15）		4.06（3.52，4.92）		668.02（460.92，1 125.48）		154.82（123.26，226.79）
Z	1.039						0.609		2.440^＊		0.023		2.382^＊		3.212^＊
组别		NLR			CLR			CAR		LMR		Alb/（g/L）		LeCR/（×10⁹/mg）		PAR
轻症组		2.09（1.43，2.99）			1.08（0.25，5.56）			0.05（0.10，0.22）		4.29（2.82，5.56）		43.80（42.30，46.83）		3.24（0.76，14.03）		5.69（5.09，6.42）
重症组		2.57（1.85，4.10）			5.56（1.64，21.94）			0.23（0.07，0.61）		3.60（2.20，4.77）		42.30（37.83，45.58）		0.64（0.22，2.15）		6.34（5.28，8.01）
Z		2.032^＊			4.277^＊			4.312^＊		1.661		2.957^＊		4.711^＊		2.884^＊

组别			n	男性		年龄/岁		ESR/（mm/1 h）		CRP/（mg/L）		WBC/（×10⁹/L）		PLT/（×10⁹/L）		MPV/fL
轻症组			100	44（29.7）		40.4±13.7		14.50（5.00，20.53）		2.29（0.47，9.40）		7.10（5.69，8.27）		244.50（223.25，277.75）		9.70（9.00，10.74）
重症组			48	29（19.6）		43.1±15.7		23.75（14.25，53.75）		11.34（5.88，51.11）		6.25（5.50，7.30）		272.50（237.00，331.50）		9.50（8.75，10.00）
χ²、t或Z				0.061		1.079		4.575^＊		5.497^＊		1.846		2.280^＊		2.058^＊
组别	Hb/（g/L）						MON/（×10⁹/L）		LYM/（×10⁹/L）		NEU/（×10⁹/L）		SII		PLR
轻症组	131.50（121.25，144.50）						0.46（0.38，0.60）		1.85（1.56，2.34）		4.38（2.97，5.46）		533.79（356.49，789.81）		137.49（100.38，170.33）
重症组	130.00（120.00，142.00）						0.46（0.37，0.57）		1.67（1.14，2.15）		4.06（3.52，4.92）		668.02（460.92，1 125.48）		154.82（123.26，226.79）
Z	1.039						0.609		2.440^＊		0.023		2.382^＊		3.212^＊
组别		NLR			CLR			CAR		LMR		Alb/（g/L）		LeCR/（×10⁹/mg）		PAR
轻症组		2.09（1.43，2.99）			1.08（0.25，5.56）			0.05（0.10，0.22）		4.29（2.82，5.56）		43.80（42.30，46.83）		3.24（0.76，14.03）		5.69（5.09，6.42）
重症组		2.57（1.85，4.10）			5.56（1.64，21.94）			0.23（0.07，0.61）		3.60（2.20，4.77）		42.30（37.83，45.58）		0.64（0.22，2.15）		6.34（5.28，8.01）
Z		2.032^＊			4.277^＊			4.312^＊		1.661		2.957^＊		4.711^＊		2.884^＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
CRP	0.039	0.012	11.368	0.001	1.040	1.017~1.064
ESR	0.058	0.013	20.564	<0.001	1.059	1.033~1.086
PLT	0.006	0.003	4.904	0.027	1.006	1.001~1.011
LYM	-0.689	0.289	5.696	0.017	0.502	0.285~0.884
Alb	-0.094	0.038	5.996	0.014	0.910	0.844~0.981
NLR	0.142	0.081	3.120	0.077	1.153	0.985~1.350
PLR	0.007	0.002	8.280	0.004	1.007	1.002~1.011
CLR	0.014	0.006	6.098	0.014	1.014	1.003~1.025
CAR	0.400	0.181	4.870	0.027	1.491	1.046~2.126
SII	0.001	<0.001	4.563	0.033	1.001	1.000~1.001
LeCR	-0.097	0.032	8.997	0.003	0.908	0.852~0.967
PAR	0.322	0.107	9.118	0.003	1.379	1.119~1.700

变量	β	SE	Wald χ²	P	OR	OR 95%CI
CRP	0.039	0.012	11.368	0.001	1.040	1.017~1.064
ESR	0.058	0.013	20.564	<0.001	1.059	1.033~1.086
PLT	0.006	0.003	4.904	0.027	1.006	1.001~1.011
LYM	-0.689	0.289	5.696	0.017	0.502	0.285~0.884
Alb	-0.094	0.038	5.996	0.014	0.910	0.844~0.981
NLR	0.142	0.081	3.120	0.077	1.153	0.985~1.350
PLR	0.007	0.002	8.280	0.004	1.007	1.002~1.011
CLR	0.014	0.006	6.098	0.014	1.014	1.003~1.025
CAR	0.400	0.181	4.870	0.027	1.491	1.046~2.126
SII	0.001	<0.001	4.563	0.033	1.001	1.000~1.001
LeCR	-0.097	0.032	8.997	0.003	0.908	0.852~0.967
PAR	0.322	0.107	9.118	0.003	1.379	1.119~1.700

变量	β	SE	Wald χ²	P	OR	OR 95%CI
CRP	0.014	0.011	1.721	0.190	1.014	0.993~1.035
ESR	0.053	0.017	9.545	0.002	1.054	1.019~1.090
PLT	-0.031	0.020	2.349	0.125	0.970	0.932~1.009
MPV	0.083	0.217	0.146	0.702	1.086	0.711~1.661
LYM	-0.220	0.676	0.106	0.745	0.803	0.213~3.019
Alb	0.240	0.143	2.815	0.093	1.271	0.960~1.681
NLR	1.037	0.674	2.367	0.124	2.822	0.75310.580
PLR	0.010	0.007	2.039	0.153	1.011	0.996~1.025
CLR	-0.001	0.026	0.002	0.960	0.999	0.950~1.050
CAR	0.139	0.905	0.023	0.878	1.149	0.195~6.772
SII	-0.005	0.003	3.949	0.047	0.995	0.989~1.000
LeCR	-0.080	0.039	4.224	0.040	0.923	0.856~0.996
PAR	1.719	0.897	3.667	0.055	5.576	0.960~32.376
常数项	-15.651	7.975	3.851	0.050	<0.001