Department of Respiratory Medicine, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China.
Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
J Clin Lab Anal. 2020 Sep;34(9):e23415. doi: 10.1002/jcla.23415. Epub 2020 Jun 2.
This study aimed to investigate clinical characteristics, laboratory indexes, treatment regimens, and short-term outcomes of severe and critical coronavirus disease 2019 (COVID-19) patients.
One hundred and sixty one consecutive severe and critical COVID-19 patients admitted in intensive care unit (ICU) were retrospectively reviewed in this multicenter study. Demographic features, medical histories, clinical symptoms, lung computerized tomography (CT) findings, and laboratory indexes on admission were collected. Post-admission complications, treatment regimens, and clinical outcomes were also documented.
The mean age was 59.38 ± 16.54 years, with 104 (64.60%) males and 57 (35.40%) females. Hypertension (44 [27.33%]) and diabetes were the most common medical histories. Fever (127 [78.88%]) and dry cough (111 [68.94%]) were the most common symptoms. Blood routine indexes, hepatic and renal function indexes, and inflammation indexes were commonly abnormal. Acute respiratory distress syndrome (ARDS) was the most common post-admission complication (69 [42.86%]), followed by electrolyte disorders (48 [29.81%]), multiple organ dysfunction (MODS) (37 [22.98%]), and hypoproteinemia (36 [22.36%]). The most commonly used antiviral drug was lopinavir/ritonavir tablet. 50 (31.06%) patients died, while 78 (48.45%) patients healed and discharged, and the last 33 (20.50%) patients remained in hospital. Besides, the mean hospital stay of deaths was 21.66 ± 11.18 days, while the mean hospital stay of discharged patients was 18.42 ± 12.77 days. Furthermore, ARDS (P < .001) and MODS (P = .008) correlated with increased mortality rate.
Severe and critical COVID-19 presents with high mortality rate, and occurrence of ARDS or MODS greatly increases its mortality risk.
本研究旨在探讨重症和危重症 2019 冠状病毒病（COVID-19）患者的临床特征、实验室指标、治疗方案和短期转归。
对多中心回顾性研究中收治于重症监护病房（ICU）的 161 例连续重症和危重症 COVID-19 患者的人口统计学特征、既往病史、临床症状、肺部计算机断层扫描（CT）表现以及入院时的实验室指标进行了收集。还记录了患者的入院后并发症、治疗方案和临床结局。
患者的平均年龄为 59.38±16.54 岁，其中男性 104 例（64.60%），女性 57 例（35.40%）。高血压（44 例[27.33%]）和糖尿病是最常见的既往病史。发热（127 例[78.88%]）和干咳（111 例[68.94%]）是最常见的症状。血常规、肝肾功能和炎症指标通常异常。入院后最常见的并发症是急性呼吸窘迫综合征（ARDS）（69 例[42.86%]），其次是电解质紊乱（48 例[29.81%]）、多器官功能障碍（MODS）（37 例[22.98%]）和低蛋白血症（36 例[22.36%]）。最常用的抗病毒药物是洛匹那韦/利托那韦片。50 例（31.06%）患者死亡，78 例（48.45%）患者治愈出院，33 例（20.50%）患者仍在住院治疗。此外，死亡患者的平均住院时间为 21.66±11.18 天，治愈出院患者的平均住院时间为 18.42±12.77 天。此外，ARDS（P<.001）和 MODS（P=.008）与死亡率增加相关。
重症和危重症 COVID-19 患者的死亡率较高，ARDS 或 MODS 的发生大大增加了其死亡风险。
