COVID-19 患者严重急性呼吸综合征冠状病毒 2 病毒阳性持续时间的早期危险因素。

Early Risk Factors for the Duration of Severe Acute Respiratory Syndrome Coronavirus 2 Viral Positivity in Patients With Coronavirus Disease 2019.

机构信息

Biological Resource Center, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang, China.

Department of Infectious Diseases, Enze Hospital, Taizhou Enze Medical Center (Group), Luqiao, Zhejiang, China.

出版信息

Clin Infect Dis. 2020 Nov 19;71(16):2061-2065. doi: 10.1093/cid/ciaa490.

DOI:10.1093/cid/ciaa490

PMID:32337591

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7197613/

Abstract

BACKGROUND

Pneumonia coronavirus disease 2019 (COVID-19) has became a pandemic. However, information on early risk factors for the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral positivity is not yet available.

METHODS

In this prospective study, a cohort of 137 patients with confirmed SARS-CoV-2 were enrolled. Clinical information and laboratory data were retrieved from electronic medical records. Viral positivity duration was calculated by the interval from the day of confirmed SARS-CoV-2 positive results to the day SARS-CoV-2 testing showed negative results in these 137 patients with COVID-19. Early risk factors for the duration of SARS-CoV-2 viral positivity were evaluated.

RESULTS

The median SARS-CoV-2 viral positivity duration is 12 days (range, 4 to ~45) for this cohort. Cox regression results showed a significantly shorter viral positivity duration was related to younger age (hazard ratio [HR], .658; P = .017); disease not being severe (HR, .653; P = .076); higher lymphocyte (HR, 1.464; P = .033), eosinophil (HR, 1.514; P = .020), and CD8+ T-cell (HR, 1.745; P = .033) counts; and lower IL-6 (HR, .664; P = .036) and IL-10 (HR, .631; P = .021). Multivariate analysis with covariable-adjusted results showed that the CD8+ T-cell count (HR, 2.376; P= .114) was a predominant risk factor for the duration of SARS-CoV-2 viral positivity.

CONCLUSIONS

Our findings show early laboratory parameters such as CD8+ T-cell count to be risk factors for the duration of SARS-CoV-2 viral positivity, which has significance in the control and prevention of the disease.

摘要

背景

新型冠状病毒肺炎（COVID-19）已经大流行。然而，关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）病毒阳性持续时间的早期危险因素的信息尚不清楚。

方法

在这项前瞻性研究中，纳入了 137 例确诊 SARS-CoV-2 的患者。从电子病历中检索临床信息和实验室数据。通过计算这 137 例 COVID-19 患者从确诊 SARS-CoV-2 阳性结果到 SARS-CoV-2 检测转为阴性的天数来计算病毒阳性持续时间。评估 SARS-CoV-2 病毒阳性持续时间的早期危险因素。

结果

本队列中 SARS-CoV-2 病毒阳性持续时间的中位数为 12 天（范围，4 至~45）。Cox 回归结果表明，病毒阳性持续时间较短与年龄较小（危险比[HR]，.658；P=.017）、疾病不严重（HR，.653；P=.076）、淋巴细胞计数较高（HR，1.464；P=.033）、嗜酸性粒细胞计数较高（HR，1.514；P=.020）、CD8+T 细胞计数较高（HR，1.745；P=.033）、IL-6 较低（HR，.664；P=.036）和 IL-10 较低（HR，.631；P=.021）相关。多变量分析和协变量调整结果表明，CD8+T 细胞计数（HR，2.376；P=.114）是 SARS-CoV-2 病毒阳性持续时间的主要危险因素。