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以色列感染新型冠状病毒2的患者的特征和结局:急诊科入院时实验室检查结果与随后呼吸衰竭之间的相关性

Characteristics and Outcomes of Patients Infected with SARS-CoV-2 in Israel: Correlation between Laboratory Findings on Admission to Emergency Department and Subsequent Respiratory Failure.

作者信息

Elhadad Dana, Bronstein Yotam, Yana Moshe, Baris Harel, Levinger Uriel, Shapiro Maurice, Sharon Nechama

机构信息

Department of Internal Medicine Ward, Laniado Medical Center, Netanya, Israel.

Department of Pediatric Hematology-Oncology, Laniado Medical Center, Netanya, Israel.

出版信息

Isr Med Assoc J. 2020 Oct;22(10):605-611.

Abstract

BACKGROUND

There is limited clinical information on coronavirus disease-19 (COVID-19) patients in Israel.

OBJECTIVES

To describe the characteristics, outcomes, and potential associations of hospitalized COVID-19 patients in Israel.

METHODS

We conducted a single-center, retrospective study of 58 consecutive laboratory-confirmed COVID-19 patients admitted to Laniado Hospital, Israel, between 14 March 2020 and 14 May 2020. Demographic, clinical, and laboratory data on admission were collected and analyzed, and the association to subsequent respiratory failure was assessed.

RESULTS

Mean age of patients was 70.7 ± 16.9 years (53% males, 47% females.); 74% had at least one co-morbidity. Most patients were of Jewish Ashkenazi descent. During hospitalization 15 patients (mean age 78.18 ± 10.35 years); 80% male, 73% Sephardi descent developed respiratory failure rates of 60% occurring on average 10.6 days following intubation. Laboratory tests at admission displayed a significant increase in C-reactive protein (CRP) and creatine kinase (CK) and a decrease in absolute lymphocyte count (ALC) in patients who eventually developed respiratory failure (163.97 mg/L, 340.87 IU/L, 0.886 K/μl vs. 50.01 mg/L and 123.56 IU/L, 1.28 K/μl, respectively). Multivariate logistic analysis revealed an integrated parameter of CRP, CK, and ALC highly correlated with respiratory failure. Receiver operating characteristic curve revealed the area under the curve of CRP, CK, and ALC and the integrated parameter to be 0.910, 0.784, and 0.754, respectively. CRP was the strongest predictor to correlate with respiratory failure.

CONCLUSIONS

CRP, CK, and ALC levels on admission could possibly be used to detect high-risk patients prone to develop respiratory failure.

摘要

背景

以色列关于冠状病毒病-19(COVID-19)患者的临床信息有限。

目的

描述以色列住院COVID-19患者的特征、结局及潜在关联。

方法

我们对2020年3月14日至2020年5月14日期间连续收治入以色列拉尼亚多医院的58例实验室确诊的COVID-19患者进行了单中心回顾性研究。收集并分析入院时的人口统计学、临床和实验室数据,并评估其与随后呼吸衰竭的关联。

结果

患者的平均年龄为70.7±16.9岁(男性占53%,女性占47%);74%的患者至少有一种合并症。大多数患者为阿什肯纳兹犹太裔。住院期间,15例患者(平均年龄78.18±10.35岁;男性占80%,塞法迪裔占73%)发生呼吸衰竭,插管后平均10.6天发生率为60%。最终发生呼吸衰竭的患者入院时实验室检查显示C反应蛋白(CRP)和肌酸激酶(CK)显著升高,绝对淋巴细胞计数(ALC)降低(分别为163.97mg/L、340.87IU/L、0.886K/μl,而未发生呼吸衰竭患者分别为50.01mg/L和123.56IU/L、1.28K/μl)。多因素逻辑分析显示,CRP、CK和ALC的综合参数与呼吸衰竭高度相关。受试者工作特征曲线显示,CRP、CK、ALC及综合参数的曲线下面积分别为0.910、0.784和0.754。CRP是与呼吸衰竭相关性最强的预测指标。

结论

入院时的CRP、CK和ALC水平可能用于检测易发生呼吸衰竭的高危患者。

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