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Serum Amyloid A is a biomarker of severe Coronavirus Disease and poor prognosis - 14/05/20

Doi : 10.1016/j.jinf.2020.03.035 
Huan Li a, #, Xiaochen Xiang b, #, Hongwei Ren a, #, Lingli Xu a, Lisha Zhao a, Xiaoqiong Chen a, Hui Long a, , Qiang Wang b, , Qingming Wu a, b,
a Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, China 
b Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China 

Corresponding authors.⁎⁎Corresponding author at: Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China.Institute of Infection, Immunology and Tumor MicroenvironmentHubei Province Key Laboratory of Occupational Hazard Identification and ControlMedical CollegeWuhan University of Science and TechnologyWuhan430065China

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Highlights

The level of SAA and CRP significantly increased in patients with COVID-19.
As disease progressed from mild to critically severe, SAA and CRP gradually increased.
Our study indicated that SAA/L, CRP, SAA, and l are valuable in predicting the severity and distinguishing critically ill patients from mild ones.
Patients with higher initial SAA are more likely to have poor CT imaging.

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Summary

Background

To explore the significance of SAA in evaluating the severity and prognosis of COVID-19.

Methods

A total of 132 patients with confirmed COVID-19 who were admitted to a designated COVID-19 hospital in Wuhan, China from January 18, 2020 to February 26, 2020 were collected. The dynamic changes of blood SAA, CRP, PCT, WBC, Lymphocyte (L), PLT, CT imaging, and disease progression were studied. All patients completed at least twice laboratory data collection and clinical condition assessment at three time points indicated for this study; The length of hospital stay was longer than 14 days prior to February 26, 2020.

Results

COVID-19 patients had significantly increased SAA and CRP levels, while L count decreased, and PCT, WBC, and PLT were in the normal range. As disease progressed from mild to critically severe, SAA and CRP gradually increased, while L decreased, and PLT, WBC, and PCT had no significant changes; ROC curve analysis suggests that SAA/L, CRP, SAA, and L count are valuable in evaluating the severity of COVID-19 and distinguishing critically ill patients from mild ones; Patients with SAA consistently trending down during the course of disease have better prognosis, compared with the patients with SAA continuously rising; The initial SAA level is positively correlated with the dynamic changes of the serial CT scans. Patient with higher initial SAA level are more likely to have poor CT imaging.

Conclusions

SAA and L are sensitive indicators in evaluating the severity and prognosis of COVID-19. Monitoring dynamic changes of SAA, combined with CT imaging could be valuable in diagnosis and treatment of COVID-19.

Le texte complet de cet article est disponible en PDF.

Keywords : Coronavirus Disease 2019, Serum amyloid A, C-reactive protein, Lymphocyte, Computed tomography imaging, Severity


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© 2020  Publié par Elsevier Masson SAS.
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Vol 80 - N° 6

P. 646-655 - juin 2020 Retour au numéro
Article précédent Article précédent
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