单细胞分布宽度预测了COVID-19中的败血症,呼吸衰竭和死亡
Amanda Frugoli1, Johnson Ong1, Brittany Meyer1
1Graduate Medical Education/Internal Medicine, Community Memorial Hospital, Ventura, USA.
Cureus
|January 15, 2024
概括
单细胞分布宽度 (MDW) 有效检测COVID-19患者的败血症,与疾病严重程度和死亡率相关. 这种随时可用的实验室标志物有助于早期识别和分类,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 实验室血液学 实验室血液学
背景情况:
- 败血症是医院死亡的主要原因,需要早期检测以改善患者的治疗结果.
- 在毒症的识别和管理中,COVID-19感染带来了独特的挑战.
- 单细胞分布宽度 (MDW) 被探索为检测败血症的潜在细胞标志物.
研究的目的:
- 调查单细胞分布宽度 (MDW) 在检测COVID-19患者中败血症的实用性.
- 评估MDW与疾病严重程度,临床结果和COVID-19死亡率的相关性.
- 为了比较MDW的性能与已确定的炎症标志物.
主要方法:
- 成年COVID-19患者的回顾性,单中心队列研究.
- 评估单细胞分布宽度 (MDW) 作为败血症的预测生物标志物.
- MDW与前素,D-二聚合物,费里丁和乳酸水平的比较.
主要成果:
- 在COVID-19患者中,MDW显著预测了败血症 (25.50 ± 5.93对比 23.13 ± 4.46,p < 0.01).
- MDW与呼吸衰竭,缺氧和死亡相关,截止值为24.9,表明致命结果 (AUC0.69,灵敏度为83%,特异性为71%).
- MDW与COVID-19结果有显著的关联 (OR = 3.52,p < 0.001),但与其他炎症标志物没有相关性.
结论:
- 单细胞分布宽度 (MDW) 是可靠的细胞标志物,用于检测COVID-19中的败血症.
- 较高的MDW值与呼吸衰竭,死亡和整体死亡率的风险增加有关.
- MDW提供了一个有价值的,易于访问的工具,用于COVID-19患者的急诊室分拣.
相关概念视频
Pneumonia II: Pathophysiology
The pathophysiology of pneumonia involves the following steps:
Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Acute Respiratory Failure-V
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Respiratory Syncytial Virus Disease
Human respiratory syncytial virus (RSV) is a widespread pathogen that primarily targets infants and young children but also poses a serious health risk to elderly and immunocompromised individuals. Belonging to the Pneumoviridae family, RSV is a negative-sense, single-stranded RNA virus within the Pneumovirus genus. Its global health burden is significant, with millions of cases annually resulting in hospitalizations and mortality, particularly in resource-limited settings. Although most...


