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25 例 COVID-19 死亡病例的临床特征:对中国武汉某单一医疗中心病历的回顾性研究。

Clinical characteristics of 25 death cases with COVID-19: A retrospective review of medical records in a single medical center, Wuhan, China.

机构信息

Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Int J Infect Dis. 2020 May;94:128-132. doi: 10.1016/j.ijid.2020.03.053. Epub 2020 Apr 3.

Abstract

OBJECTIVES

This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality.

METHODS

The clinical records, laboratory findings and radiological assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data.

RESULTS

The age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-dimer, LDH and lactate levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts.

CONCLUSIONS

The clinical characteristics of 25 death cases with COVID-19 we summarized, which would be helpful to identify critically ill patients of COVID-19 early and reduce their mortality.

摘要

目的

总结新型冠状病毒肺炎(COVID-19)死亡病例的临床特征,早期识别危重症 COVID-19 患者,降低病死率。

方法

回顾性分析 2020 年 1 月 14 日至 2 月 13 日武汉大学人民医院 25 例 COVID-19 死亡患者的临床资料,包括病历、实验室检查和影像学(胸部 X 线或 CT)等,由 2 名经验丰富的临床医师对数据进行提取和总结。

结果

年龄和基础疾病(高血压、糖尿病等)是 COVID-19 肺炎死亡的最重要危险因素。细菌感染可能在促进患者死亡中起重要作用。营养不良在重症患者中很常见。可观察到多器官功能障碍,最常见的器官损伤是肺,其次是心脏、肾脏和肝脏。中性粒细胞、血清淀粉样蛋白 A、降钙素原、C 反应蛋白、肌钙蛋白 I、D-二聚体、乳酸脱氢酶和乳酸水平的升高可作为疾病进展的指标,淋巴细胞计数的下降也是如此。

结论

总结了 25 例 COVID-19 死亡病例的临床特征,有助于早期识别危重症 COVID-19 患者,降低病死率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9137/7128884/124d8aab4298/gr1_lrg.jpg

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