中国感染控制杂志2023，Vol.22Issue(12)：1468-1474,7.DOI:10.12138/j.issn.1671-9638.20234277
系统性红斑狼疮患者合并COVID-19后发生肺炎的危险因素
Risk factors for the development of pneumonia after SARS-CoV-2 infection in patients with systemic lupus erythematosus
摘要
Abstract
Objective To explore the risk factors for the development of pneumonia in patients with systemic lupus erythematosus(SLE)following infection with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods A total of 250 SLE patients who received chest CT examination and were diagnosed with COVID-19 at the Department of Rheumatology and Immunology in the First Affiliated Hospital of Nanchang University from De-cember 2022 to February 2023 were included in analysis.Patient were divided into the control group and the pneu-monia group according to chest CT results.Demographic data,clinical data,and laboratory indicators of patients in two groups of patients were collected.Laboratory data of patients before completing the chest CT examination were evaluated.Diagnostic capability of age,C-reactive protein/lymphocyte(CLR),and systemic immune inflammation index/albumin(SII/ALB)in evaluating the development of pneumonia in SLE patients with COVID-19 were deter-mined by calculating the receiver operating characteristic(ROC)curve.Results Among 250 SLE patients with COVID-19,188(75.2％)didn't develop pneumonia and were assigned into the control group;62(24.8％)devel-oped pneumonia in the pneumonia group.There were statistically significant differences between the two groups in terms of age,COVID-19 vaccination status,complications of renal insufficiency,cardiovascular disease or diabetes,neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),lymphocyte/monocyte ratio(LMR),sys-temic immune inflammation index(SII),SII/albumin(SII/ALB)and C-reactive protein to lymphocyte ratio(CLR)(all P＜0.05).Among SLE patients who developed pneumonia after developing COVID-19,the levels of SII/ALB and CLR were higher than those of non-pneumonia patients,with statistically significant differences(both P＜0.05).Multivariate logistic regression analysis showed that age,SII/ALB,and CLR were independent risk factors for pneumonia in SLE patients with COVID-19(all P＜0.05).ROC curve analysis showed the area under the CLR curve of 0.791,sensitivity of 90.3％,and specificity of 57.4％,with good diagnostic value.Conclusion Age,SII/ALB,and CLR are risk factors for pneumonia in SLE patients with COVID-19.More attention needs to be paid on populations with these characteristics in clinical practice,so as to reduce the occurrence of complications and im-prove prognosis.关键词
系统性红斑狼疮/COVID-19/新冠病毒感染/肺炎/炎症标志物/危险因素Key words
systemic lupus erythematosus/COVID-19/SARS-CoV-2 infection/pneumonia/inflammatory indi-cator/risk factor分类
医药卫生引用本文复制引用
刘鹏程,张敏,李建斌,余淑娇,吴锐..系统性红斑狼疮患者合并COVID-19后发生肺炎的危险因素[J].中国感染控制杂志,2023,22(12):1468-1474,7.基金项目
国家自然科学基金(82260898) （82260898）
