Objective To analyze the diagnostic value of neutrophil to lymphocyte ratio(NLR)and D-dimer in predicting the pro-gression of novel coronavirus disease 2019(COVID-19)pneumonia to severe disease.Methods 194 COVID-19 pneumonia patients admitted to our hospital from December 18,2022 to January 16,2023 were selected as the study subjects.According to whether the pa-tient has severe pneumonia,they are divided into a severe group(42 cases)and a non-severe group(152 cases).Compare the clinical characteristics and laboratory test indicators of two groups of patients and analyze the correlation between NLR and D-Dimer with acute physiology and chronic health(APACHE Ⅱ)scores at admission.Establish an individualized early warning model through binary logis-tic regression and verify the diagnostic value of the model.Results The age,APACHE Ⅱ score,serum WBC,NEU,NLR,D-Dimer levels,and the proportion of patients with concomitant coronary heart disease in the severe group were significantly higher than those in the non-severe group,while LYM was significantly lower than that in the non-severe group(P＜0.05).Among them,NLR was posi-tively correlated with APACHE Ⅱ score(r=0.587,P＜0.05),while D-Dimer was negatively correlated with APACHE Ⅱ score(r=0.673,P＜0.05).Binary logistic regression analysis suggests that an increase in NLR levels is an independent risk factor for the ex-acerbation of COVID-19 pneumonia in patients(OR=1.522,95％CI:1.141-2.031),while a increase in D-Dimer levels is an inde-pendent risk factor(OR=1.084,95％CI:1.016-1.156).The ROC curve analysis shows that the AUC of the model for predicting se-vere pneumonia is 0.929,with sensitivity and specificity of 95.2％and 84.2％,respectively,significantly improved compared to a sin-gle indicator.Conclusion The increase in NLR levels or the decrease in D-Dimer levels in COVID-19 pneumonia patients are close-ly related to the occurrence of severe pneumonia.The personalized early warning model established based on these two indicators has high diagnostic value for predicting severe pneumonia.
维普
万方数据