Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
Department of Infectious Diseases, Dongguan People's Hospital, Southern Medical University, Dongguan, Guangdong Province, China.
Clin Ther. 2020 Jun;42(6):964-972. doi: 10.1016/j.clinthera.2020.04.009. Epub 2020 Apr 27.
The purpose of this study was to determine the risk factors associated with pneumonia, acute respiratory distress syndrome (ARDS), and clinical outcome among patients with novel coronavirus disease 2019 (COVID-19).
This was a cross-sectional multicenter clinical study. A total of 95 patients infected with COVID-19 were enrolled. The COVID-19 diagnostic standard was polymerase chain reaction detection of target genes of 2019 novel coronavirus (2019-nCoV). Clinical, laboratory, and radiologic results, as well as treatment outcome data, were obtained. ARDS was defined as an oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen) ≤300 mm Hg.
Multivariate analysis showed that older age (odds ratio [OR], 1.078; p = 0.008) and high body mass index (OR, 1.327; p = 0.024) were independent risk factors associated with patients with pneumonia. For patients with ARDS, multivariate analysis showed that only high systolic blood pressure (OR, 1.046; p = 0.025) and high lactate dehydrogenase level (OR, 1.010; p = 0.021) were independent risk factors associated with ARDS. A total of 70 patients underwent CT imaging repeatedly after treatment. Patients were divided in a disease exacerbation group (n = 19) and a disease relief group (n = 51). High body mass index (OR, 1.285; p = 0.017) and tobacco smoking (OR, 16.13; p = 0.032) were independent risk factors associated with disease exacerbation after treatment.
These study results help in the risk stratification of patients with 2019-nCoV infection. Patients with risk factors should be given timely intervention to avoid disease progression.
本研究旨在确定与新型冠状病毒病 2019（COVID-19）患者肺炎、急性呼吸窘迫综合征（ARDS）和临床结局相关的危险因素。
这是一项横断面多中心临床研究。共纳入 95 例感染 COVID-19 的患者。COVID-19 的诊断标准为聚合酶链反应检测 2019 年新型冠状病毒（2019-nCoV）的靶基因。获得临床、实验室和影像学结果以及治疗结局数据。ARDS 定义为氧合指数（动脉血氧分压/吸入氧分数）≤300mmHg。
多因素分析显示，年龄较大（比值比[OR]，1.078；p=0.008）和高体重指数（OR，1.327；p=0.024）是与肺炎患者相关的独立危险因素。对于 ARDS 患者，多因素分析显示，只有高收缩压（OR，1.046；p=0.025）和高乳酸脱氢酶水平（OR，1.010；p=0.021）是与 ARDS 相关的独立危险因素。共有 70 例患者在治疗后反复进行 CT 成像。患者分为疾病恶化组（n=19）和疾病缓解组（n=51）。高体重指数（OR，1.285；p=0.017）和吸烟（OR，16.13；p=0.032）是治疗后疾病恶化的独立危险因素。
这些研究结果有助于对 2019-nCoV 感染患者进行风险分层。应及时对有危险因素的患者进行干预，以避免疾病进展。
