RESUMEN
The outbreak of coronavirus disease (COVID-19) has brought great challenges to the world. The objectives of this study were to describe the baseline characteristics and changes of biomarkers of these COVID-19 patients and identify predictive value of the above markers for patient death. Using patient death as the observational endpoints, clinical data of inpatients in a special ward for COVID-19 in Wuhan, China were retrospectively collected. Univariate and multivariate Cox regression analyses were used to evaluate prognostic value of baseline characteristics and laboratory data changes. This study included clinical data of 75 patients. Age, c-reactive protein (CRP) and interleukin-6 levels were independent predictors of patient death. Survivors were characterized as having declining neutrophil counts, D-dimer, N-terminal pronatriuretic peptide, troponin I (TnI) and c-reactive protein levels, while counts of lymphocyte gradually came back. Non-survivors were characterized with increasing white blood cell counts (WBC) and neutrophil counts. Changes of WBC, TnI and interleukin-6 were also independently associated with patient death. Older age, baseline CRP and IL-6 levels may be used as meaningful predictors to identify patients with poor prognosis. Changes of biomarkers should be closely monitored in the management of patients with COVID-19, while constantly increasing levels of WBC, TnI and interleukin-6 in the disease course also predict patient death.
Asunto(s)
Biomarcadores/análisis , COVID-19/sangre , COVID-19/mortalidad , Adulto , Anciano , Análisis de Varianza , Biomarcadores/sangre , Recuento de Células Sanguíneas/métodos , Recuento de Células Sanguíneas/estadística & datos numéricos , COVID-19/epidemiología , China/epidemiología , Progresión de la Enfermedad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Linfocitos/microbiología , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico/análisis , Péptido Natriurético Encefálico/sangre , Neutrófilos/microbiología , Fragmentos de Péptidos/análisis , Fragmentos de Péptidos/sangre , Pronóstico , Modelos de Riesgos Proporcionales , Curva ROC , Estudios Retrospectivos , Troponina I/análisis , Troponina I/sangreAsunto(s)
COVID-19/sangre , Linfocitos/microbiología , Linfopenia/diagnóstico , Anciano , COVID-19/complicaciones , COVID-19/fisiopatología , Enfermedad Crítica/epidemiología , Enfermedad Crítica/mortalidad , Femenino , Humanos , Linfopenia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel ß-coronavirus, is the main pathogenic agent of the rapidly spreading pneumonia called coronavirus disease 2019 (COVID-19). SARS-CoV-2 infects much more people, especially the elder population, around the world than other coronavirus, such as SARS-CoV and MERS-CoV, which is challenging current global public health system. Beyond the pathogenesis of SARS-CoV-2, microbial coinfection plays an important role in the occurrence and development of SARS-CoV-2 infection by raising the difficulties of diagnosis, treatment, prognosis of COVID-19, and even increasing the disease symptom and mortality. We summarize the coinfection of virus, bacteria and fungi with SARS-CoV-2, their effects on COVID-19, the reasons of coinfection, and the diagnosis to emphasize the importance of microbial coinfection in COVID-19. KEY POINTS: ⢠Microbial coinfection is a nonnegligible factor in COVID-19. ⢠Microbial coinfection exacerbates the processes of the occurrence, development and prognosis of COVID-19, and the difficulties of clinical diagnosis and treatment. ⢠Different virus, bacteria, and fungi contributed to the coinfection with SARS-CoV-2.