小柯机器人

武汉大学李红良等研究人员合作发现，中性粒细胞与淋巴细胞的比例决定了糖皮质激素治疗COVID-19患者的临床疗效。相关论文于2021年1月5日在线发表在《细胞—代谢》杂志上。

研究人员将来自湖北省21家医院的12862例COVID-19病例平均分配给了培训和验证队列。研究人员发现入院时嗜中性粒细胞与淋巴细胞之比（NLR）> 6.11可以判别较高死亡率。然而，重要的是，在此类个体中使用皮质类固醇激素治疗可降低60天全因死亡率的风险。相反，在NLR≤6.11或2型糖尿病的个体中，皮质类固醇激素的治疗与死亡率降低无关，而与高血糖症和感染风险增加相关。

这些结果表明，在所研究的队列中，皮质类固醇治疗与非糖尿病且具有NLR定义下严重症状的部分COVID-19患者的有益结果相关。

据介绍，皮质类固醇激素疗法被推荐用于重度COVID-19患者。但是一个关键问题是如何客观地分辨可能从这种治疗中受益的重症患者。 

附：英文原文

Title: The neutrophil-to-lymphocyte ratio determines clinical efficacy of corticosteroid therapy in patients with COVID-19

Author: Jingjing Cai, Haomiao Li, Changjiang Zhang, Ze Chen, Hui Liu, Fang Lei, Juan-Juan Qin, Ye-Mao Liu, Feng Zhou, Xiaohui Song, Jianghua Zhou, Yan-Ci Zhao, Bin Wu, Meiling He, Huilin Yang, Lihua Zhu, Peng Zhang, Yan-Xiao Ji, Guang-Nian Zhao, Zhigang Lu, Liming Liu, Weiming Mao, Xiaofeng Liao, Haofeng Lu, Daihong Wang, Xigang Xia, Xiaodong Huang, Xiang Wei, Jiahong Xia, Bing-Hong Zhang, Yufeng Yuan, Zhi-Gang She, Qingbo Xu, Xinliang Ma, Yibin Wang, Juan Yang, Xin Zhang, Xiao-Jing Zhang, Hongliang Li

Issue&Volume: 2021-01-05

Abstract: Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19.But one key question is how to objectively identify severely ill patients who maybenefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitalsin Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyteratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly,however, corticosteroid treatment in such individuals was associated with a lowerrisk of 60-day all-cause mortality. Conversely, in individuals with an NLR ≤ 6.11or with Type 2 Diabetes, corticosteroid treatment was not associated with reducedmortality, but rather increased risks of hyperglycemia and infections. These resultsshow that in the studied cohort corticosteroid treatment is associated with beneficialoutcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptomsas defined by NLR.

DOI: 10.1016/j.cmet.2021.01.002

Source: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(21)00002-4

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