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在新冠病毒疾病治疗期间,合并症评估至关重要。

Comorbidity Assessment Is Essential During COVID-19 Treatment.

作者信息

Jakhmola Shweta, Indari Omkar, Baral Budhadev, Kashyap Dharmendra, Varshney Nidhi, Das Ayan, Chatterjee Sayantani, Jha Hem Chandra

机构信息

Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India.

出版信息

Front Physiol. 2020 Aug 4;11:984. doi: 10.3389/fphys.2020.00984. eCollection 2020.

Abstract

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV2 is associated with various comorbidities; cardiovascular diseases, hypertension, diabetes, liver, lung diseases, and neurological ailments. The majority of the dysfunctions mentioned above are often associated with endothelial deterioration, indicating that endothelium can be the target of SARS-CoV2. Our study is an exclusive observational study that quantitatively analyses COVID-19 related comorbidities. We retrieved the data of % population of COVID-19 hospitalized and deceased patients with associated comorbidities from publicly accessible portals of the five European countries. A two tailed -test enabled us to determine the significant proportions of deaths compared to hospitalized patients with associated comorbidity. Our study revealed that deaths associated with cardiovascular diseases and diabetes are highly significant ( < 0.0001) compared to hospitalized in countries like Italy, France, and Spain unlike the Netherlands. Deaths from kidney diseases (Italy- < 0.0001; Sweden- < 0.0001; Netherlands- = 0.0001; France- = 0.0033) and neurological ailments (France- = 0.0001; Netherlands- < 0.0001) are significantly higher than the total hospitalized patients affected by the particular comorbidity. We have noted that deaths due to liver diseases are least associated with COVID-19 among all comorbidities. Intriguingly, immunodeficiency shows mixed outcomes in death proportions compared to the hospital admitted individuals. Besides, the treatment regime involves drugs like losartan, ACE inhibitors, angiotensin-receptor blockers, Remdesivir, Chloroquine, Hydroxychloroquine, etc. may modulate the severity of the comorbidities. These comorbidities can create chaos in the existing healthcare system and may worsen the disease outcome.

摘要

由严重急性呼吸综合征冠状病毒2型(SARS-CoV2)引起的2019冠状病毒病(COVID-19)与多种合并症相关;心血管疾病、高血压、糖尿病、肝脏疾病、肺部疾病和神经系统疾病。上述大多数功能障碍通常与内皮细胞恶化有关,这表明内皮细胞可能是SARS-CoV2的靶点。我们的研究是一项独家观察性研究,定量分析了与COVID-19相关的合并症。我们从五个欧洲国家可公开访问的门户网站中检索了COVID-19住院和死亡患者及其相关合并症的人口百分比数据。双尾检验使我们能够确定与患有相关合并症的住院患者相比,死亡的显著比例。我们的研究表明,与意大利、法国和西班牙等国家的住院患者不同,荷兰的心血管疾病和糖尿病相关死亡非常显著(P<0.0001)。肾病导致的死亡(意大利-P<0.0001;瑞典-P<0.0001;荷兰-P = 0.0001;法国-P = 0.0033)和神经系统疾病导致的死亡(法国-P = 0.0001;荷兰-P<0.0001)明显高于受特定合并症影响的住院患者总数。我们注意到,在所有合并症中,肝脏疾病导致的死亡与COVID-19的关联最小。有趣的是,与住院患者相比,免疫缺陷在死亡比例方面呈现出混合结果。此外,治疗方案涉及氯沙坦、ACE抑制剂、血管紧张素受体阻滞剂、瑞德西韦、氯喹、羟氯喹等药物,可能会调节合并症的严重程度。这些合并症会给现有的医疗系统带来混乱,并可能使疾病结果恶化。

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