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中国武汉新冠肺炎重症和非重症患者的临床特征和生存分析:一项单中心回顾性病例对照研究。

Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study.

机构信息

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Department of Medical Intensive Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

Sci Rep. 2020 Oct 16;10(1):17524. doi: 10.1038/s41598-020-74465-3.

Abstract

Since the outbreak of COVID-19 in China at the end of 2019, the world has experienced a large-scale epidemic caused by the SARS-CoV-2. The epidemiological and clinical course of COVID-19 patients has been reported, but there have been few analyses about the characteristics, predictive risk factors, and outcomes of critical patients. In this single-center retrospective case-control study, 90 adult inpatients hospitalized at Tongji Hospital (Wuhan, China) were included. Demographic, clinical, laboratory tests, and treatment data were obtained and compared between critical and non-critical patients. We found that compared with non-critical patients, the critical patients had higher SOFA score and qSOFA scores. Critical patients had lower lymphocyte and platelet count, elevated D-dimer, decreased fibrinogen, and elevated high-sensitivity C-reactive protein (hsCRP), and interleukin-6(IL-6). More critical patients received treatment including antibiotics, anticoagulation, corticosteroid, and oxygen therapy than non-critical ones. Multivariable regression showed higher qSOFA score and elevation of IL-6 were related to critical patients. Antibiotic usage and anticoagulation were associated with decreased in-hospital mortality. And critical grouping contributed greatly to in-hospital death. Critical COVID-19 patients have a more severe clinical course. qSOFA score and elevation of IL-6 are risk factors for critical condition. Non-critical grouping, positive antibiotic application, and anticoagulation may be beneficial for patient survival.

摘要

自 2019 年底中国爆发 COVID-19 以来,世界经历了由 SARS-CoV-2 引起的大规模疫情。已经报道了 COVID-19 患者的流行病学和临床过程,但对重症患者的特征、预测风险因素和结局的分析较少。在这项单中心回顾性病例对照研究中,纳入了 90 名在华中科技大学同济医院(中国武汉)住院的成年患者。比较了重症和非重症患者的人口统计学、临床、实验室检查和治疗数据。结果发现,与非重症患者相比,重症患者的 SOFA 评分和 qSOFA 评分更高。重症患者的淋巴细胞和血小板计数较低,D-二聚体升高,纤维蛋白原降低,高敏 C 反应蛋白(hsCRP)和白细胞介素 6(IL-6)升高。更多的重症患者接受了包括抗生素、抗凝、皮质类固醇和氧疗在内的治疗。多变量回归显示,较高的 qSOFA 评分和升高的 IL-6 与重症有关。抗生素的使用和抗凝与住院死亡率降低有关。重症分组对住院死亡有很大影响。重症 COVID-19 患者的临床过程更严重。qSOFA 评分和 IL-6 的升高是重症的危险因素。非重症分组、抗生素应用阳性和抗凝可能有利于患者生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3fc/7567789/d2b6be6dadb9/41598_2020_74465_Fig1_HTML.jpg

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