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中国武汉 101 例重症 COVID-19 患者基线临床和 HRCT 表现的预后价值。

Prognostic value of baseline clinical and HRCT findings in 101 patients with severe COVID-19 in Wuhan, China.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.

出版信息

Sci Rep. 2020 Oct 16;10(1):17543. doi: 10.1038/s41598-020-74497-9.

DOI:10.1038/s41598-020-74497-9
PMID:33067524
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7567846/
Abstract

The aim of this study was to assess the prognostic value of baseline clinical and high resolution CT (HRCT) findings in patients with severe COVID-19. In this retrospective, two-center study, we included two groups of inpatients with severe COVID-19 who had been discharged or died in Jin Yin-tan hospital and Wuhan union hospital between January 5, 2020, and February 22, 2020. Cases were confirmed by real-time polymerase chain reaction. Demographic, clinical, and laboratory data, and HRCT imaging were collected and compared between discharged and deceased patients. Univariable and multivariable logistic regression models were used to assess predictors of mortality risk in these patients. 101 patients were included in this study, of whom 66 were discharged and 35 died in the hospital. The mean age was 56.6 ± 15.1 years and 67 (66.3%) were men. Of the 101 patients, hypertension (38, 37.6%), cardiovascular disease (21,20.8%), diabetes (18,17.8%), and chronic pulmonary disease (16,15.8%) were the most common coexisting conditions. The multivariable regression analysis showed older age (OR: 1.142, 95% CI 1.059-1.231, p < 0.001), acute respiratory distress syndrome (ARDS) (OR: 10.142, 95% CI 1.611-63.853, p = 0.014), reduced lymphocyte count (OR: 0.004, 95% CI 0.001-0.306, p = 0.013), and elevated HRCT score (OR: 1.276, 95% CI 1.002-1.625, p = 0.049) to be independent predictors of mortality risk on admission in severe COVID-19 patients. These findings may have important clinical implications for decision-making based on risk stratification of severe COVID-19 patients.

摘要

本研究旨在评估基线临床和高分辨率 CT(HRCT)在重症 COVID-19 患者中的预后价值。在这项回顾性、双中心研究中,我们纳入了 2020 年 1 月 5 日至 2 月 22 日期间在金银潭医院和武汉协和医院住院的两组重症 COVID-19 出院或死亡患者。病例通过实时聚合酶链反应确诊。收集并比较了出院和死亡患者的人口统计学、临床和实验室数据以及 HRCT 影像学资料。采用单变量和多变量逻辑回归模型评估这些患者死亡风险的预测因素。本研究共纳入 101 例患者,其中 66 例出院,35 例死亡。患者平均年龄为 56.6±15.1 岁,67 例(66.3%)为男性。101 例患者中,高血压(38 例,37.6%)、心血管疾病(21 例,20.8%)、糖尿病(18 例,17.8%)和慢性肺部疾病(16 例,15.8%)是最常见的合并症。多变量回归分析显示,年龄较大(OR:1.142,95%CI 1.059-1.231,p<0.001)、急性呼吸窘迫综合征(ARDS)(OR:10.142,95%CI 1.611-63.853,p=0.014)、淋巴细胞计数减少(OR:0.004,95%CI 0.001-0.306,p=0.013)和 HRCT 评分升高(OR:1.276,95%CI 1.002-1.625,p=0.049)是重症 COVID-19 患者入院时死亡风险的独立预测因素。这些发现可能对基于重症 COVID-19 患者风险分层的决策具有重要的临床意义。

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