Respiratory Hospital of the Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China.
Institute of Respiratory Diseases, Xiamen Medical College, Xiamen, China.
J Med Virol. 2020 Oct;92(10):2124-2129. doi: 10.1002/jmv.25998. Epub 2020 Jun 2.
Studies have demonstrated that comorbidities, especially cardiovascular and endocrine diseases, correlated with poorer clinical outcomes. However, the impact of digestive system diseases has not been issued. The aim of this study is to determine the impact of laryngopharyngeal reflux disease (LPRD) on hospitalized patients with coronavirus disease 2019 (COVID-19). We extracted clinical data regarding 95 patients in Wuhan Jinyintan Hospital, Wuhan, China, between 26 January and 21 February 2020. The Reflux Symptom Index (RSI) was used to assess the presence and severity of LPRD. An RSI greater than 13 is considered to be abnormal. A total of 95 patients with COVID-19 were enrolled, with 61.1% (58/95), 32.6% (31/95), and 6.3% (6/95) being moderately ill, severely ill, and critically ill, respectively. In this study, 38.9% (37/95) of the patient had an RSI score over 13, which was indicative of LPRD. In univariable analysis, the age and RSI scores of severely or critically ill patients were statistically significantly higher than patients with moderate disease (P = .026 and P = .005, respectively). After controlling for age difference in a multivariable model, the RSI greater than 13, compared to RSI equal to 0, was associated with significantly higher risk of severe infection (P < .001; odds ratio [OR] = 11.411; 95% confidence interval [CI], 2.95-42.09) and critical infection (P = .028; OR= 19.61; 95% CI, 1.38-277.99). Among hospitalized patients with COVID-19, RSI scores greater than 13, indicative of LPRD, correlated with poorer clinical outcomes. The prevalence of LPRD may be higher than the general population, which indicated that COVID-19 can impair the upper esophageal sphincter and aggravate reflux.
研究表明，合并症，特别是心血管和内分泌疾病，与较差的临床结局相关。然而，消化系统疾病的影响尚未得到证实。本研究旨在确定喉咽反流病（LPRD）对 2019 年冠状病毒病（COVID-19）住院患者的影响。我们提取了中国武汉金银潭医院 95 例患者的临床数据，时间为 2020 年 1 月 26 日至 2 月 21 日。反流症状指数（RSI）用于评估 LPRD 的存在和严重程度。RSI 大于 13 被认为是异常的。共纳入 95 例 COVID-19 患者，其中 61.1%（58/95）、32.6%（31/95）和 6.3%（6/95）分别为中度、重度和危重症。在本研究中，38.9%（37/95）的患者 RSI 评分超过 13，提示存在 LPRD。单变量分析显示，重度或危重症患者的年龄和 RSI 评分明显高于中度疾病患者（P = .026 和 P = .005）。在多变量模型中控制年龄差异后，RSI 大于 13 与严重感染的风险显著增加相关（P < .001；比值比[OR] = 11.411；95%置信区间[CI]，2.95-42.09）和危重症感染（P = .028；OR = 19.61；95%CI，1.38-277.99）。在 COVID-19 住院患者中，RSI 评分大于 13，提示 LPRD 与较差的临床结局相关。LPRD 的患病率可能高于一般人群，这表明 COVID-19 可损害食管上括约肌并加重反流。
