COVID-19 成年住院患者的临床特征、结局和预后因素。
Clinical characteristics, outcomes and prognosticators in adult patients hospitalized with COVID-19.
机构信息
Division of General Internal Medicine and Geriatrics, IU School of Medicine, IU Health Physicians Inpatient Medicine, Indianapolis, IN.
IU School of Medicine Transitional Residency, Indianapolis, IN.
出版信息
Am J Infect Control. 2021 Feb;49(2):158-165. doi: 10.1016/j.ajic.2020.07.005. Epub 2020 Jul 8.
BACKGROUND
COVID-19 is a novel disease caused by SARS-CoV-2.
METHODS
We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into 3 groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV, and those who received MV and died during hospitalization.
RESULTS
There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8, 55.8 and 72.7 years, respectively (P = .0001). Of those who received MV and died, 61% were male (P = .01). More than half the patients (n = 90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, lactate dehydrogenase >445.6 units/L, and brain natriuretic peptide (BNP) >104.75 pg/mL had odds ratios of 10.5, 5, 4.5 and 2.9, respectively for MV (P < .05 for all). Peak BNP >167.5 pg/mL had an odds ratio of 6.7 for inpatient mortality when mechanically ventilated (P = .02).
CONCLUSIONS
Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, lactate dehydrogenase and BNP may serve as early indicators of disease trajectory.
背景
COVID-19 是一种由 SARS-CoV-2 引起的新型疾病。
方法
我们对 2020 年 3 月在一个地点住院的 COVID-19 患者进行了回顾性评估。患者分为 3 组：未接受机械通气（MV）的幸存者、接受 MV 的幸存者和住院期间接受 MV 并死亡的患者。
结果
共 140 例住院患者，22 例死亡（死亡率为 15.7%），83 例（59%）存活且未接受 MV，35 例（25%）接受 MV 且存活，18 例（12.9%）接受 MV 并死亡。每组的平均年龄分别为 57.8、55.8 和 72.7 岁（P=0.0001）。在接受 MV 并死亡的患者中，61%为男性（P=0.01）。超过一半的患者（n=90，64%）为非裔美国人。首次测量的 D-二聚体>575.5ng/mL、降钙素原>0.24ng/mL、乳酸脱氢酶>445.6 单位/L 和脑钠肽（BNP）>104.75pg/mL 的患者接受 MV 的比值比分别为 10.5、5、4.5 和 2.9（所有 P<0.05）。在接受机械通气的患者中，峰值 BNP>167.5pg/mL 的住院死亡率的比值比为 6.7（P=0.02）。
结论
年龄和性别可能影响 COVID-19 的结局。D-二聚体、降钙素原、乳酸脱氢酶和 BNP 可能作为疾病轨迹的早期指标。
Zotero 插件