The application value of serum amyloid A in the severity and prognosis of viral pneumonia
XIONG Xuefang, ZHONG Ying, SUN Debin.
Department of Respiratory and Critical Care Medicine, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui 323300, China
XIONG Xuefang,ZHONG Ying,SUN Debin.. The application value of serum amyloid A in the severity and prognosis of viral pneumonia[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(3): 199-204.
Abstract：Objective: To investigate the clinical application value of serum amyloid A (SAA) in grading the severity of viral pneumonia and evaluating the prognosis of patients with severe disease. Methods: A t tal of 250 ospitalized patients with viral pneumonia admitted to Lishui Central Hospital from December 2022 to June 2023 ere selected and divided into two groups: non-severe group and severe group. The differences in SAA, CRP,procalcitonin (PCT), total white blood cell (WBC) and neutrophil ratio between the two groups were compared.The ROC curve was used to evaluate the value of each indicator in identifying critically ill patients. According to he survival outcome, patients with severe disease were divided into survival group and non-survival group, and the difference in five indicators between the two groups was compared, and the prognostic value of the different indicators in severe patients was evaluated by ROC curve. Results: The levels of SAA, CRP, PCT, white blood cell count and neutrophil ratio in severe group were significantly higher than those in non-severe group, with statistical significance (P<0.05). The ROC curve analysis showed that the AUC of SAA was 0.869, the cutoff
value 226.05 mg/L, and the sensitivity and specificity were 94.1% and 63.7%, respectively. SAA had the best identification efficiency for patients with severe viral pneumonia. Multivariate Logistic regression analysis showed that age ≥88.5 years old, SAA≥226.05 mg/L, central granulocyte ratio ≥88.75% were risk factors for severe viral pneumonia. The levels of SAA and PCT in non-survival group were significantly higher than those in survival group, with significant difference (P<0.05). ROC curve analysis showed that the AUC of SAA was 0.576,the cutoff value 639.35 mg/L, and the sensitivity and specificity were 82.1% and 43.7%, respectively. Conclusion: SAA level can be used as a sensitive index to evaluate the severity of viral pneumonia as it is more effective than CRP, PCT, total white blood cell counts and neutrophil ratio in differentiating non-severe and severe viral pneumonia. It is also has application value in evaluating the prognosis of severe patients.
