It is difficult to distinguish between the new crown common type and A and B influenza infection? These two routine blood parameters should be read!
Original Sun Huabao Wang Tao Laboratory Medicine Network Yesterday
Author: Huabao Sun, Wang Tao, Nanchang Ninth Hospital
The Novel Coronavirus Treatment Protocol (Trial Version 7) [1] clearly states that the mild manifestations of novel coronavirus pneumonia (CoVID-19) need to be distinguished from upper respiratory tract infections caused by other viruses, and the main viruses to be distinguished include influenza virus, adenovirus, and respiratory syncytial virus.
In order to investigate the value of routine blood parameters for the differentiation of novel coronavirus infection from influenza A virus (H1N1) and influenza B virus (BB) infection, we retrospectively studied the results of the first admission Myriad BC-6000 Plus blood cell analyzer in 42 patients with novel coronavirus common type infection, 63 patients with influenza A infection and 34 patients with influenza B. All routine blood analysis The results were divided into neo-coronary infection group, influenza A infection group and influenza B infection group. We compared and studied the differences of each parameter of blood routine between the groups, and investigated the value of blood routine parameters to identify neo-coronary infection and influenza A and B infection, expecting to achieve the purpose of preliminary screening of neo-coronary infection and influenza A and B infection through blood routine.
Results
1. Differences in routine blood results between the neo-coronary group, the influenza A group and the influenza B group.
The results of the study showed that LYM% (lymphocyte percentage) and RDW-SD (standard deviation of red blood cell volume distribution) were significantly different between the neo-coronary group and the influenza A group, and between the neo-coronary group and the influenza B group.
Figure 1 Distribution of test results between different groups for each parameter
ANOVA was performed between the three groups for the above parameters (WBC, Neu%, Lym% and RDW-SD), and the P values were all less than 0.05, and there were significant differences between the three groups.
Table 1 ANOVA results between the three groups of newly crowned infected group, A-flu infected group and B-flu infected group
The results of ANOVA showed that the P values of Lym% and RDW-SD were <0.05 in the New Coronary Infected Group and New Coronary Infected Group, and the P value of RDW-SD was <0.05 in the New Coronary Infected Group and New Coronary Infected Group, respectively. The differences in WBC and Neu% for neo-crown vs. b-flu were not significant.
Table 2 Comparison between the neo-coronary infection group, A-flu infection group and B-flu infection group
2. Study of the value of routine blood parameters for screening of neo-coronary.
SPSS was used to perform binary logistic regression analysis of Lym% and RDW-SD between the newly crowned patient group and the non-neoconcentration patient group (influenza A + influenza B), and the results of the analysis are shown in the table below. The P values of Lym% and RDW-SD were less than 0.001, and the regression coefficients of Lym% and RDW-SD were 0.146 and -0.393, respectively, with significant effects of the two parameters.
Table 3 Results of binary logistic regression analysis of Lym% and RDW-SD in the newly crowned patient group and the non-neoconstituted patient group (influenza A + influenza B)
The AUC of Lym% and RDW-SD were 0.813 and 0.710, respectively. The AUC of the integration parameter of Lym% and RDW-SD using binary logistic regression reached 0.859 when the Cut-off was taken to be 0.240, after ROC analysis with positive test results in the neo-coronary infection group and negative results in the influenza A and influenza B infection groups. The specificity was 73.2% and sensitivity was 83.3% for screening neo-coronary and metabolic flow, so the Lym%+RDW-SD integration parameter was valuable for screening both neo-coronary and metabolic flow infections.
Figure 2 ROC analysis with different parameters
Summary
Influenza A is highly pathogenic to humans and has caused several worldwide pandemics. The occurrence of variant subtypes is called avian influenza, which is also an acute infectious disease, and the symptoms after infection are mainly manifested by high fever and cough with pneumonia and small airway dysfunction, while influenza B infection is also characterized by symptoms such as fever, dry cough, generalized aches and pains and malaise, so the clinical manifestations of influenza A and influenza B have some similarity with neo-crown.
We hope that the results of routine blood tests can achieve a preliminary differentiation between neo-crown infection and A-B flu infection, and the study of 50 patients with A-flu by Xueji Shen et al. showed that the results of Lym% in patients with A-flu infection were 14.9±5.6, which was predominantly low [2], which is consistent with our findings and lower than those of patients with neo-crown common type infection. The RDW-SD was also significantly different between the neo-crown group, the influenza A group and the influenza B group.
Our binary logistic regression analysis by Lym% and RDW-SD to integrate the new parameters showed an AUC of 0.859, respectively, which is valuable for screening neo-coronary infections versus influenza A and B infections, and we will collect more cases to verify this study result subsequently.
[Reference].
1. Office of the National Health and Wellness Commission, Office of the State Administration of Traditional Chinese Medicine. Treatment protocol for novel coronavirus pneumonia (trial version 7).
2. Shen X.K., Li C.D., Liu J. et al. Analysis and clinical significance of initial blood routine in patients with influenza A [J]. Experimental and Laboratory Medicine, 2016, 34(5), 663-665.
Edited by Bling Reviewed by Rose
