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预测冠状病毒病的严重程度及其不良临床结局。

Prediction of the Severity of the Coronavirus Disease and Its Adverse Clinical Outcomes.

机构信息

The Respiratory Department, the Second Affiliated Hospital of Harbin Medical University, China.

出版信息

Jpn J Infect Dis. 2020 Nov 24;73(6):404-410. doi: 10.7883/yoken.JJID.2020.194. Epub 2020 May 29.

Abstract

This study aims to investigate blood and biochemical laboratory findings in patients with severe coronavirus disease 2019 (COVID-19) and to develop a joint predictor for predicting the likelihood of severe COVID-19 and its adverse clinical outcomes and to provide more information for treatment. We collected the data of 88 patients with laboratory-confirmed COVID-19. Further, the patients were divided into a non-severe group and a critical group (including critically ill cases). Univariate analysis showed that the absolute lymphocyte count, albumin level, albumin/globulin ratio, lactate dehydrogenase level, interleukin-6 (IL-6) level, erythrocyte count, globulin level, blood glucose level, and age were significantly correlated with the severity of COVID-19. The multivariate binary logistic regression model revealed that age, absolute lymphocyte count, and IL-6 level were independent risk factors in patients with COVID-19. The receiver operating characteristic curve revealed that the combination of IL-6 level, absolute lymphocyte count, and age is superior to a single factor as predictors for severe COVID-19, regardless of whether it is in terms of the area under the curve or the prediction sensitivity and specificity. Early application is beneficial to early identification of critically ill patients and timing individual treatments to reduce mortality.

摘要

本研究旨在探讨重症 2019 冠状病毒病(COVID-19)患者的血液和生化实验室检查结果,并建立联合预测因子以预测 COVID-19 重症及其不良临床结局的可能性,为治疗提供更多信息。我们收集了 88 例经实验室确诊的 COVID-19 患者的数据。进一步将患者分为非重症组和危重症组(包括重症病例)。单因素分析显示,绝对淋巴细胞计数、白蛋白水平、白蛋白/球蛋白比值、乳酸脱氢酶水平、白细胞介素 6(IL-6)水平、红细胞计数、球蛋白水平、血糖水平和年龄与 COVID-19 的严重程度显著相关。多因素二元逻辑回归模型显示,年龄、绝对淋巴细胞计数和 IL-6 水平是 COVID-19 患者的独立危险因素。受试者工作特征曲线显示,IL-6 水平、绝对淋巴细胞计数和年龄的组合作为 COVID-19 重症的预测因子优于单一因素,无论在曲线下面积还是预测敏感性和特异性方面。早期应用有利于早期识别重症患者并及时进行个体化治疗,以降低死亡率。

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