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巴基斯坦首批100例新冠肺炎确诊住院患者的临床特征、特点及转归:卡拉奇一家三级护理医院的单中心回顾性研究

Clinical Profiles, Characteristics, and Outcomes of the First 100 Admitted COVID-19 Patients in Pakistan: A Single-Center Retrospective Study in a Tertiary Care Hospital of Karachi.

作者信息

Asghar Muhammad Sohaib, Haider Kazmi Syed Jawad, Ahmed Khan Noman, Akram Mohammed, Ahmed Khan Salman, Rasheed Uzma, Hassan Maira, Memon Gul Muhammad

机构信息

Internal Medicine, Dow International Medical College, Dow University Hospital, Dow University of Health Sciences, Karachi, PAK.

Emergency Medicine, Liaquat National Hospital and Medical College, Karachi, PAK.

出版信息

Cureus. 2020 Jun 20;12(6):e8712. doi: 10.7759/cureus.8712.

Abstract

Background and objective COVID-19 is a highly disseminating viral disease imparted by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), which was declared a global pandemic by the World Health Organization. In our study, we aimed to describe the clinical characteristics of the first 100 hospitalized patients of confirmed COVID-19 in a developing country. Materials and methods The study included all the admitted patients (n = 100) having COVID-19 polymerase chain reaction (PCR) positive, and evaluated clinical profiles and characteristics of the patients linking to disease severity. Results Out of the 100 patients, 67 were in the ward, 33 were in ICU, 78 of them recovered, while 22 deaths reported. The mean age was 52.58 ± 15.68, with most frequent comorbidities are diabetes and hypertension while frequent symptoms are fever and dry cough. Bilateral lower zone patchy infiltrates are frequent chest radiographic findings. Amongst the patients admitted in ICU, there were significant differences in the total leukocyte count (P = 0.001), neutrophils and lymphocytes (P =< 0.001), monocytes (P = 0.027), urea (P =< 0.001), creatinine (P = 0.002), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) increasing with disease severity, lymphocyte-to-monocyte ratio (LMR) and lymphocyte-to-C-reactive protein ratio (LCR) decreasing with mortalities. Gamma-glutamyl transferase (GGT) followed by aspartate aminotransferase (AST) are frequent hepatic derangements, while C-reactive protein (CRP) levels predicting ICU admission with area under the curve (AUC): 0.806, positive predictive value (PPV): 85.1% and lactate dehydrogenase (LDH) predicting mortality with AUC: 0.877, PPV: 97.3%, while NLR (AUC: 0.806, PPV: 95.8%) for mortality and neutrophils (AUC: 0.773, PPV: 87.5%) for ICU patients. Conclusion A number of factors are linked with disease severity and mortality along with dynamic changes of the laboratory investigations during hospital stay affecting prognosis.

摘要

背景与目的

新型冠状病毒肺炎(COVID-19)是一种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的高度传播性病毒性疾病,世界卫生组织已宣布其为全球大流行疾病。在我们的研究中,我们旨在描述一个发展中国家首批100例确诊COVID-19住院患者的临床特征。材料与方法:该研究纳入了所有COVID-19聚合酶链反应(PCR)检测呈阳性的入院患者(n = 100),并评估了与疾病严重程度相关的患者临床资料和特征。结果:100例患者中,67例在病房,33例在重症监护病房(ICU),其中78例康复,22例死亡。平均年龄为52.58±15.68岁,最常见的合并症是糖尿病和高血压,常见症状是发热和干咳。双侧下肺斑片状浸润是常见的胸部X线表现。在入住ICU的患者中,总白细胞计数(P = 0.001)、中性粒细胞和淋巴细胞(P =<0.001)、单核细胞(P = 0.027)、尿素(P =<0.001)、肌酐(P = 0.002)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)随疾病严重程度增加,淋巴细胞与单核细胞比值(LMR)和淋巴细胞与C反应蛋白比值(LCR)随死亡率降低。γ-谷氨酰转移酶(GGT)其次是天冬氨酸氨基转移酶(AST)是常见的肝脏紊乱指标,而C反应蛋白(CRP)水平预测入住ICU的曲线下面积(AUC)为0.806,阳性预测值(PPV)为85.1%,乳酸脱氢酶(LDH)预测死亡率的AUC为0.877,PPV为97.3%,而NLR(AUC:0.806,PPV:95.8%)用于预测死亡率,中性粒细胞(AUC:0.773,PPV:87.5%)用于预测ICU患者情况。结论:许多因素与疾病严重程度和死亡率相关,同时住院期间实验室检查的动态变化会影响预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c76c/7372235/8d53a2622eae/cureus-0012-00000008712-i01.jpg

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