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马德里一家医院的首批100例新冠肺炎病例,随访2个月。

The first 100 cases of COVID-19 in a Hospital in Madrid with a 2-month follow-up.

作者信息

Muñoz P, Galar A, Catalán P, Valerio M, Aldamiz-Echevarría T, Cólliga C, Bouza E

机构信息

Alicia Galar, Servicio de Microbiología y E. Infecciosas, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain.

出版信息

Rev Esp Quimioter. 2020 Oct;33(5):369-378. doi: 10.37201/req/072.2020. Epub 2020 Jul 30.

Abstract

OBJECTIVE

There are few descriptions of the clinical presentation and evolution of consecutive SARS-CoV-2 infections with a long-enough follow up.

METHODS

Description of the first consecutive 100 patients with microbiologically-proven COVID-19 in a large hospital in Madrid, Spain including a minimum of two-month follow up.

RESULTS

The median age of the patients (52% males) was 61.5 years (IQR=39.5-82.0) and the median BMI was 28.8 kg/m2 (IQR=24.7-33.7). Overall 72% of the patients had one or more co-morbid conditions with a median age-adjusted Charlson index of 2 (IQR=0-5.7). Five patients (5%) were immunosuppressed. The most common symptoms at the time of diagnosis were fever (80.0%), cough (53.0%) and dyspnea (23.0%). The median O2 saturation at the time of first examination was 94% (IQR=90-97). Chest X-ray on admission was compatible with pneumonia in 63% of the cases (bilateral in 42% and unilateral in 21%). Overall, 30% were managed at home and 70% were admitted to the hospital. Thirteen patients were admitted to the ICU with a median of 11 days of stay in the Unit (IQR=6.0-28.0). CALL score of our population ranged from 4 to 13. Overall, 60.0% of patients received antibiotic treatment and 66.0%, empirical antiviral treatment, mainly with lopinavir/ritonavir (65%) or hydroxychloroquine (42%). Mortality, with a minimum of 60 days of follow up, was 23%. The median age of the deceased patients was 85 years (IQR=79-93).

CONCLUSIONS

We found a high mortality in the first 100 patients diagnosed with COVID-19 at our institution, associated with advanced age and the presence of serious underlying diseases.

摘要

目的

对于连续发生的新型冠状病毒2(SARS-CoV-2)感染,进行足够长时间随访后对其临床表现及病情演变的描述较少。

方法

描述西班牙马德里一家大型医院中首批连续100例经微生物学证实的新型冠状病毒病(COVID-19)患者,随访时间至少为两个月。

结果

患者的中位年龄为61.5岁(男性占52%),中位体重指数(BMI)为28.8kg/m²(四分位间距[IQR]=24.7 - 33.7)。总体而言,72%的患者有一种或多种合并症,年龄调整后的查尔森指数中位数为2(IQR=0 - 5.7)。5例患者(5%)存在免疫抑制。诊断时最常见的症状为发热(80.0%)、咳嗽(53.0%)和呼吸困难(23.0%)。首次检查时的中位血氧饱和度为94%(IQR=90 - 97)。入院时胸部X线检查显示63%的病例符合肺炎表现(双侧肺炎占42%,单侧肺炎占21%)。总体而言,30%的患者居家治疗,70%的患者入院治疗。13例患者入住重症监护病房(ICU),在该病房的中位住院时间为11天(IQR=6.0 - 28.0)。我们研究人群的CALL评分范围为4至13分。总体而言,60.0%的患者接受了抗生素治疗,66.0%的患者接受了经验性抗病毒治疗,主要使用洛匹那韦/利托那韦(65%)或羟氯喹(42%)。在至少60天的随访期内,死亡率为23%。死亡患者的中位年龄为85岁(IQR=79 - 93)。

结论

我们发现,在我们机构首批诊断为COVID-19的100例患者中,死亡率较高,这与高龄及存在严重基础疾病有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5821/7528411/c800a79dee23/revespquimioter-33-369-g001.jpg

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