Choi Min Hyuk, Ahn Hyunmin, Ryu Han Seok, Kim Byung-Jun, Jang Joonyong, Jung Moonki, Kim Jinuoung, Jeong Seok Hoon
Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul 06273, Korea.
Department of Laboratory Medicine, Armed Forces Daegu Hospital, Daegu 712-906, Korea.
J Clin Med. 2020 Jun 23;9(6):1959. doi: 10.3390/jcm9061959.
A rapid increase in the number of patients with coronavirus disease 19 (COVID-19) may overwhelm the available medical resources. We aimed to evaluate risk factors for disease severity in the early stages of COVID-19. The cohort comprised 293 patients with COVID-19 from 5 March 2020, to 18 March 2020. The Korea Centers for Disease Control and Prevention (KCDC) classification system was used to triage patients. The clinical course was summarized, including the impact of drugs (angiotensin II receptor blockers [ARB], ibuprofen, and dipeptidyl peptidase-4 inhibitors [DPP4i]) and the therapeutic effect of lopinavir/ritonavir. After adjusting for confounding variables, prior history of drug use, including ARB, ibuprofen, and DPP4i was not a risk factor associated with disease progression. Patients treated with lopinavir/ritonavir had significantly shorter progression-free survival than those not receiving lopinavir/ritonavir. KCDC classification I clearly distinguished the improvement/stabilization group from the progression group of COVID-19 patients (AUC 0.817; 95% CI, 0.740-0.895).
新型冠状病毒肺炎(COVID-19)患者数量的迅速增加可能会使现有的医疗资源不堪重负。我们旨在评估COVID-19早期疾病严重程度的风险因素。该队列包括2020年3月5日至2020年3月18日期间的293例COVID-19患者。采用韩国疾病控制与预防中心(KCDC)分类系统对患者进行分类。总结了临床病程,包括药物(血管紧张素II受体阻滞剂[ARB]、布洛芬和二肽基肽酶-4抑制剂[DPP4i])的影响以及洛匹那韦/利托那韦的治疗效果。在对混杂变量进行校正后,包括ARB、布洛芬和DPP4i在内的既往用药史不是与疾病进展相关的风险因素。接受洛匹那韦/利托那韦治疗的患者无进展生存期明显短于未接受洛匹那韦/利托那韦治疗的患者。KCDC分类I能清楚地区分COVID-19患者的改善/稳定组和进展组(曲线下面积0.817;95%置信区间,0.740-0.895)。