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Early antiviral treatment contributes to alleviate the severity and improve the prognosis of patients with novel coronavirus disease (COVID-19).早期抗病毒治疗有助于减轻新型冠状病毒病 (COVID-19) 患者的病情严重程度并改善预后。
J Intern Med. 2020 Jul;288(1):128-138. doi: 10.1111/joim.13063. Epub 2020 Apr 20.
2
Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease.分析与 2019 年新型冠状病毒病住院患者疾病结局相关的因素。
Chin Med J (Engl). 2020 May 5;133(9):1032-1038. doi: 10.1097/CM9.0000000000000775.
3
Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study.中国武汉严重 COVID-19 患者的临床病程和结局:一项单中心、回顾性、观察性研究。
Lancet Respir Med. 2020 May;8(5):475-481. doi: 10.1016/S2213-2600(20)30079-5. Epub 2020 Feb 24.
4
Potential Presymptomatic Transmission of SARS-CoV-2, Zhejiang Province, China, 2020.2020 年中国浙江省新冠病毒 SARS-CoV-2 的潜在症状前传播。
Emerg Infect Dis. 2020 May;26(5):1052-1054. doi: 10.3201/eid2605.200198. Epub 2020 May 17.
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Preparing for the Most Critically Ill Patients With COVID-19: The Potential Role of Extracorporeal Membrane Oxygenation.为新冠肺炎重症患者做准备:体外膜肺氧合的潜在作用
JAMA. 2020 Apr 7;323(13):1245-1246. doi: 10.1001/jama.2020.2342.
6
Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury.从 2019 年新冠病毒感染患者中提取的临床和生化指标与病毒载量和肺部损伤有关。
Sci China Life Sci. 2020 Mar;63(3):364-374. doi: 10.1007/s11427-020-1643-8. Epub 2020 Feb 9.
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Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.中国武汉 99 例 2019 年新型冠状病毒肺炎患者的流行病学和临床特征:描述性研究。
Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30.
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.中国武汉地区 2019 年新型冠状病毒感染患者的临床特征。
Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.
9
Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6.通过降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素-6(IL-6)的实验室分析对脓毒症患者的细菌感染进行早期诊断。
Exp Ther Med. 2017 Jun;13(6):3479-3483. doi: 10.3892/etm.2017.4417. Epub 2017 May 3.
10
The etiology of lower respiratory tract infections in people with diabetes.糖尿病患者下呼吸道感染的病因
Pneumonol Alergol Pol. 2015;83(5):401-8. doi: 10.5603/PiAP.2015.0065.

一项关于 COVID-19 疾病严重程度预测因素的研究。

A Study on the Predictors of Disease Severity of COVID-19.

机构信息

Department of Infectious Diseases, Fuyang Second People's Hospital, Fuyang, Anhui, China (mainland).

Department of Public Health, Lu'an Center for Disease Control and Prevention, Lu'an, Anhui, China (mainland).

出版信息

Med Sci Monit. 2020 Sep 23;26:e927167. doi: 10.12659/MSM.927167.

DOI:10.12659/MSM.927167
PMID:32963215
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7521067/
Abstract

BACKGROUND Early and rapid identification of severe coronavirus disease 2019 (COVID-19) cases is important. The present study aimed to investigate the predictors of disease severity and thus determine the trends for disease progression early. MATERIAL AND METHODS Patients with COVID-19 were recruited from Fuyang Second People's Hospital from January to February 2020. Patients' demographic, epidemiological, and clinical data were collected, and the relationships between these variables and disease severity were analyzed. RESULTS A total of 158 cases were included according to COVID-19 diagnosis, and the treatment schemes were analyzed for identification of early indicators affecting COVID-19 progression. Severe cases accounted for 18.99% of the diagnosed cases. Analysis showed that patients' age (χ²=10.640,=0.041); the time interval between onset and diagnosis (χ²=7.278, P=0.026); the source of cases (χ²=5.557, P=0.018); fever (χ²=5.676, P=0.014); dyspnea (χ²=113.085, P<0.001); muscle or joint pain (χ²=3.900, P=0.048); chest pain (χ²=13.446, P=0.006); the levels of lymphocytes (t=2.917, P=0.014), C-reactive protein (U=730.00, P<0.001), and aspartate aminotransferase (U=1235.00, P=0.002); damage in both lungs within 3 days of admission (χ²=7.632, P=0.003); and diabetes (χ²=6.675, P=0.010) were significantly correlated with the trend of intensification. CONCLUSIONS Older age, a long time interval from onset to diagnosis, imported cases from an affected area, dyspnea, muscle or joint pain, chest pain during the course of the disease, reduced lymphocytes, elevated C-reactive protein, computed tomography scan showing damage to both lungs within 3 days of admission, and diabetes mellitus are predictors for severe COVID-19.

摘要

背景

早期快速识别严重的 2019 年冠状病毒病(COVID-19)病例非常重要。本研究旨在探讨疾病严重程度的预测因素,从而早期确定疾病进展的趋势。

材料与方法

从 2020 年 1 月至 2 月,我们从富阳市第二人民医院招募了 COVID-19 患者。收集了患者的人口统计学、流行病学和临床数据,并分析了这些变量与疾病严重程度之间的关系。

结果

根据 COVID-19 诊断,共纳入 158 例患者,并对治疗方案进行了分析,以确定影响 COVID-19 进展的早期指标。重症病例占确诊病例的 18.99%。分析表明,患者年龄(χ²=10.640,P=0.041);发病至诊断的时间间隔(χ²=7.278,P=0.026);病例来源(χ²=5.557,P=0.018);发热(χ²=5.676,P=0.014);呼吸困难(χ²=113.085,P<0.001);肌肉或关节疼痛(χ²=3.900,P=0.048);胸痛(χ²=13.446,P=0.006);淋巴细胞水平(t=2.917,P=0.014)、C 反应蛋白(U=730.00,P<0.001)和天冬氨酸转氨酶(U=1235.00,P=0.002);入院后 3 天内双肺损伤(χ²=7.632,P=0.003);以及糖尿病(χ²=6.675,P=0.010)与病情加重趋势显著相关。

结论

年龄较大、从发病到诊断的时间间隔较长、来自疫区的输入性病例、呼吸困难、肌肉或关节疼痛、胸痛、疾病过程中淋巴细胞减少、C 反应蛋白升高、入院后 3 天内 CT 扫描显示双肺损伤以及糖尿病是 COVID-19 重症的预测因素。