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奥曼首例 63 例成人住院 COVID-19 患者的临床特征和结局。

Clinical characteristics and outcomes of the first 63 adult patients hospitalized with COVID-19: An experience from Oman.

机构信息

Adult Infectious Diseases, Department of Medicine, Royal Hospital, Ministry of Health, Muscat Oman.

Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.

出版信息

J Infect Public Health. 2020 Jul;13(7):906-913. doi: 10.1016/j.jiph.2020.06.002. Epub 2020 Jun 8.

Abstract

INTRODUCTION

To identify the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Oman.

METHODS

A case series of hospitalized COVID-19 laboratory-confirmed patients between February 24th through April 24th, 2020, from two hospitals in Oman. Analyses were performed using univariate statistics.

RESULTS

The cohort included 63 patients with an overall mean age of 48±16 years and 84% (n=53) were males. A total of 38% (n=24) of the hospitalized patients were admitted to intensive care unit (ICU). Fifty one percent (n=32) of patients had at least one co-morbidity with diabetes mellitus (DM) (32%; n=20) and hypertension (32%; n=20) as the most common co-morbidities followed by chronic heart and renal diseases (12.8%; n=8). The most common presenting symptoms at onset of illness were fever (84%; n=53), cough (75%; n=47) and shortness of breaths (59%; n=37). All except two patients (97%; n=61) were treated with either chloroquine or hydroxychloroquine, while the three most prescribed antibiotics were ceftriaxone (79%; n=50), azithromycin (71%; n=45), and the piperacillin/tazobactam combination (49%; n=31). A total of 59% (n=37), 49% (n=31) and 24% (n=15) of the patients were on lopinavir/ritonavir, interferons, or steroids, respectively. Mortality was documented in (8%; n=5) of the patients while 68% (n=43) of the study cohort recovered. Mortality was associated with those that were admitted to ICU (19% vs 0; p=0.009), mechanically ventilated (31% vs 0; p=0.001), had DM (20% vs 2.3%; p=0.032), older (62 vs 47 years; p=0.045), had high total bilirubin (43% vs 2.3%; p=0.007) and those with high C-reactive protein (186 vs 90mg/dL; p=0.009) and low corrected calcium (15% vs 0%; p=0.047).

CONCLUSIONS

ICU admission, those on mechanical ventilation, the elderly, those with high total bilirubin and low corrected calcium were associated with high mortality in hospitalized COVID-19 patients.

摘要

简介

本研究旨在明确在阿曼住院的 COVID-19 患者的临床特征和结局。

方法

对 2020 年 2 月 24 日至 4 月 24 日期间,来自阿曼两家医院的 COVID-19 实验室确诊患者进行病例系列研究。采用单变量统计分析方法进行数据分析。

结果

本研究纳入了 63 名住院 COVID-19 患者,平均年龄为 48±16 岁,84%(n=53)为男性。共有 38%(n=24)的住院患者被收入重症监护病房(ICU)。51%(n=32)的患者存在至少一种合并症,其中糖尿病(DM)(32%;n=20)和高血压(32%;n=20)是最常见的合并症,其次是慢性心脏和肾脏疾病(12.8%;n=8)。发病时最常见的首发症状为发热(84%;n=53)、咳嗽(75%;n=47)和呼吸急促(59%;n=37)。除了两名患者(97%;n=61)外,其余患者均接受了氯喹或羟氯喹治疗,而使用最多的三种抗生素分别为头孢曲松(79%;n=50)、阿奇霉素(71%;n=45)和哌拉西林/他唑巴坦联合制剂(49%;n=31)。分别有 59%(n=37)、49%(n=31)和 24%(n=15)的患者接受了洛匹那韦/利托那韦、干扰素或皮质类固醇治疗。记录了 5 例(8%)患者的死亡病例,而研究队列中有 68%(n=43)的患者康复。与未入住 ICU(0% vs 19%;p=0.009)、未机械通气(0% vs 31%;p=0.001)、无 DM(2.3% vs 20%;p=0.032)、年龄较小(47 岁 vs 62 岁;p=0.045)、总胆红素水平正常(2.3% vs 43%;p=0.007)、C 反应蛋白水平正常(90mg/dL vs 186mg/dL;p=0.009)和校正钙水平正常(0% vs 15%;p=0.047)的患者相比,入住 ICU、机械通气、年龄较大、总胆红素水平较高和校正钙水平较低与 COVID-19 住院患者的高死亡率相关。

结论

入住 ICU、接受机械通气、年龄较大、总胆红素和校正钙水平较高的患者,COVID-19 住院患者死亡率较高。

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