回顾分析免疫球蛋白和补体联合白细胞水平对重症COVID-19转归的预测价值

目的:回顾性分析武汉市第三医院收治的重症新型冠状病毒肺炎(COVID-19)患者血液白细胞计数(WBC)、淋巴细胞计数(LYM)、淋巴细胞%(LYM%)、血清免疫球蛋白(IGA、IGG、IGM)以及补体(C3、C4)等指标水平，探讨其与COVID-19重症患者转归的相关性并评价其预测价值。方法:随机筛选武汉市第三医院确...

Retrospective analysis of the predictive value of immunoglobulin and complement combined leukocyte levels on the outcome of severe COVID-19

Objective To retrospectively analyze the blood leukocytes(WBC),lymphocytes(LYM),lymphocyte%(LYM%),and serum total immunoglobulin(IGA,IGG,IGM)and complement(C3,C4)index levels to explore its predictive value for the outcome of COVID-19 severe pneumonia.Methods Eighty-five COVID-19 patients with severe pneumonia diagnosed in our hospital were randomly selected and were divided into good outcome group(50 cases)and poor outcome group(35 cases).WBC,LYM,LYM%,IGA,IGG,IGM,and C3,C4 level data,and analyze the differences between the two groups,the correlation of each indicator,and ROC curves of single and joint detection to explore relationship between indicators and outcomes,and the predictive efficacy of indicators on outcomes.Results Differences in WBC,LYM,LYM%,IGG,and IGA levels were significant between the two groups(P=0.000,0.015,0.000,0.000,0.001),among them with significant differences,LYM and LYM%were significantly positively correlated(r=0.669,P=0.000),while WBC and LYM%levels were significantly negatively correlated(r=-0.600,P=0.000),WBC and IGA levels were significantly positively correlated(r=0.283,P=0.009)and IGG and IGA levels were also significantly positively correlated(r=0.0.442,P=0.000);After logistic regression analysis,WBC,LYM,LYM%,IGG,and IGA are all important influencing factors(P=0.001,0.022,0.000,0.000,0.003);but only the levels of WBC,IGG,and LYM%are Independent risk factors(P=0.034,0.004,0.001),the ROC curve of the single detection and joint detection of their predicted outcome performance,respectively,and the max AUC(AUC=0.890,P=0.000)at the time of joint testing of WBC,LYM%and IGG,index YI=0.657,it has the greatest predictive power for adverse outcomes,with a sensitivity of 77.10%and a specificity of 88.00%.IGM,C3,C4,IGG/IGM,and C3/C4 levels were not significantly different(P=0.066,0.204,0.076,0.310,0.156).Conclusions The levels of WBC,LYM,LYM%,IGG,and IGA in the early admission of COVID-19 infected patients with severe pneumonia have important predictive value for the outcome of them.WBC,LYM%and IGG levels are independent risks and joint detection of the three indexes have the best predictive performance.