白血球数上昇を呈したCOVID-19患者52例の臨床的特徴：レトロスペクティブ解析

Clinical features in 52 patients with COVID-19 who have increased leukocyte count: a retrospective analysis.

• Kaochang Zhao
• Ruiyun Li
• Xiaojun Wu
• Yang Zhao
• Tao Wang
• Zhishui Zheng
• Shaolin Zeng
• Xuhong Ding
• Hanxiang Nie

抄録

最近の報告では、コロナウイルス疾患2019（COVID-19）の患者の中に白血球数の上昇を呈した患者が割合的に存在することが示されている。これらの患者に関する臨床データは乏しい。我々は，入院時に白血球数が上昇したCOVID-19患者の臨床所見を評価することを目的とした．2020年2月3日から3月3日までに中国・武漢の武漢大学人民病院で胸部CTスキャンで異常所見を伴う肺炎を発症したCOVID-19確定患者619例のうち、入院時に白血球数が増加した52例の臨床データをレトロスペクティブに収集した。白血球数が増加した52例の平均年齢は64.7歳（SD 11.4）、男性32例（61.5％）、発熱47例（90.4％）であった。白血球数が増加した患者は、白血球数が増加していない患者と比較して、有意に高齢であり（P＜0.01）、基礎疾患がある可能性が高く（P＜0.01）、重症化する可能性が高く（P＜0.01）、入院する可能性が高かった（P＜0.01）。01）、ICUへの入院（P<0.01）、機械換気（P<0.01）、死亡率（P<0.01）が高く、好中球数、CRP、IL-6の血中濃度が有意に上昇していました（P<0.01）。基礎となる慢性疾患を有していたCOVID-19の高齢患者は、白血球症を発症する可能性が高い。これらの患者は重症化する可能性が高く、ICUへの入院率が高く、死亡率も高い。

Recent reports have showed that a proportion of patients with Coronavirus Disease 2019 (COVID-19) presented elevated leukocyte count. Clinical data about these patients is scarce. We aimed to evaluate the clinical findings of patients with COVID-19 who have increased leukocyte at admission. We retrospectively collected the clinical data on the 52 patients who have increased leukocyte count at admission from the 619 patients with confirmed COVID-19 who had pneumonia with abnormal features on chest CT scan in Renmin Hospital of Wuhan University in Wuhan, China, from February 3 to March 3, 2020. The mean age of the 52 patients with increased leukocyte count was 64.7 (SD 11.4) years, 32 (61.5%) were men and 47 (90.4%) had fever. Compared with the patients with non-increased leukocyte count, the patients with increased leukocyte count were significantly older (P < 0.01), were more likely to have underlying chronic diseases (P < 0.01), more likely to develop critically illness (P < 0.01), more likely to admit to an ICU (P < 0.01), more likely to receive mechanical ventilation (P < 0.01), had higher rate of death (P < 0.01) and the blood levels of neutrophil count and the serum concentrations of CRP and IL-6 were significantly increased, (P < 0.01). The older patients with COVID-19 who had underlying chronic disorders are more likely to develop leukocytosis. These patients are more likely to develop critical illness, with a high admission to an ICU and a high mortality rate.