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分析影响 COVID-19 患者预后和病毒脱落持续时间的因素。

Analysis of factors affecting the prognosis of COVID-19 patients and viral shedding duration.

机构信息

Department of Medical Administration, Haihe Hospital, Tianjin University, Tianjin300350, China.

Department of Prevention and infection management, Haihe Hospital, Tianjin University, Tianjin, 300350, China.

出版信息

Epidemiol Infect. 2020 Jun 25;148:e125. doi: 10.1017/S0950268820001399.

Abstract

The clinical characteristics of patients with COVID-19 were analysed to determine the factors influencing the prognosis and virus shedding time to facilitate early detection of disease progression. Logistic regression analysis was used to explore the relationships among prognosis, clinical characteristics and laboratory indexes. The predictive value of this model was assessed with receiver operating characteristic curve analysis, calibration and internal validation. The viral shedding duration was calculated using the Kaplan-Meier method, and the prognostic factors were analysed by univariate log-rank analysis and the Cox proportional hazards model. A retrospective study was carried out with patients with COVID-19 in Tianjin, China. A total of 185 patients were included, 27 (14.59%) of whom were severely ill at the time of discharge and three (1.6%) of whom died. Our findings demonstrate that patients with an advanced age, diabetes, a low PaO2/FiO2 value and delayed treatment should be carefully monitored for disease progression to reduce the incidence of severe disease. Hypoproteinaemia and the fever duration warrant special attention. Timely interventions in symptomatic patients and a time from symptom onset to treatment <4 days can shorten the duration of viral shedding.

摘要

分析了 COVID-19 患者的临床特征,以确定影响预后和病毒脱落时间的因素,从而有助于早期发现疾病进展。采用逻辑回归分析探讨预后、临床特征和实验室指标之间的关系。使用受试者工作特征曲线分析、校准和内部验证评估该模型的预测价值。采用 Kaplan-Meier 法计算病毒脱落持续时间,采用单因素 log-rank 分析和 Cox 比例风险模型分析预后因素。对中国天津的 COVID-19 患者进行了回顾性研究。共纳入 185 例患者,出院时病情严重的有 27 例(14.59%),死亡 3 例(1.6%)。我们的研究结果表明,年龄较大、患有糖尿病、低 PaO2/FiO2 值和治疗延迟的患者应密切监测疾病进展,以降低重症疾病的发生率。低蛋白血症和发热持续时间值得特别关注。及时对有症状的患者进行干预,以及从症状出现到治疗的时间<4 天,可以缩短病毒脱落的持续时间。

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