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哥伦比亚波哥大确诊感染新冠病毒的住院患者的预后因素

Prognostic factors in hospitalized patients diagnosed with SARS-CoV-2 infection, Bogotá, Colombia.

作者信息

Motta Juan Camilo, Novoa Danny Julian, Gómez Carmen Cecilia, Moreno Julian Mauricio, Vargas Lina, Pérez Jairo, Millán Henry, Arango Álvaro Ignacio

机构信息

Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia.

Servicio de Medicina Interna, Fundación Cardioinfantil, Bogotá, D.C., Colombia.

出版信息

Biomedica. 2020 Oct 30;40(Supl. 2):116-130. doi: 10.7705/biomedica.5764.

Abstract

Introduction: Infection with the new SARS-Cov-2 coronavirus is a worldwide public health emergency; its diagnosis is based on molecular tests, while its prognosis depends on the patient’s history and on some paraclinical tests. In Colombia, forecasts are not yet counted. Objective: To assess the factors associated with the development of severe disease in hospitalized patients diagnosed with SARS-CoV-2 infection, as well as the prognostic factors for the outcome of mortality. Materials and methods: We conducted an ambispective cohort study in hospitalized patients at the Fundación Cadioinfantil from March to June, 2020. Results: Of the 104 patients analyzed, 31.7% (n=33) had a severe presentation and 9.6% (n=10) had a mortality outcome. For mortality, the most important prognostic factor was the development of severe disease followed by age over 60 years and malnutrition. For the development of the severe disease, prognostic factors were a history of hemodialysis (HR=135), diabetes (HR=4.4), and an increased level of lactate dehydrogenase (LDH) (HR=1,004), while the lymphocyte count over 1,064 was a protective factor (HR=0.9). In the classification of patients, the National Early Warning Score (NEWS2) score in the high and low-risk categories corresponded to the best performance. There was no difference between the treatments administered. Conclusions: The most important prognostic factors for mortality were being over 60 years of age, hypertension, diabetes, and cirrhosis, while for the development of severe disease they were chronic kidney disease with hemodialysis, NEWS2 with high risk at admission, increased levels of LDH and C reactive protein (CRP), and leukocytosis.

摘要

引言

新型严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染是一场全球公共卫生突发事件;其诊断基于分子检测,而其预后取决于患者病史及一些临床旁检查。在哥伦比亚,尚无相关预测数据。目的:评估确诊感染SARS-CoV-2的住院患者中与重症发生相关的因素以及死亡结局的预后因素。材料与方法:我们于2020年3月至6月在卡迪奥因凡蒂尔基金会对住院患者进行了一项双向队列研究。结果:在分析的104例患者中,31.7%(n = 33)表现为重症,9.6%(n = 10)出现死亡结局。对于死亡而言,最重要的预后因素是重症的发生,其次是60岁以上年龄和营养不良。对于重症的发生,预后因素包括血液透析史(HR = 135)、糖尿病(HR = 4.4)以及乳酸脱氢酶(LDH)水平升高(HR = 1.004),而淋巴细胞计数超过1064是一个保护因素(HR = 0.9)。在患者分类中,高风险和低风险类别的国家早期预警评分(NEWS2)得分表现最佳。所给予的治疗之间无差异。结论:死亡的最重要预后因素是60岁以上、高血压、糖尿病和肝硬化,而对于重症的发生,因素包括接受血液透析的慢性肾脏病、入院时高风险的NEWS2、LDH和C反应蛋白(CRP)水平升高以及白细胞增多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07f7/7676839/8710c45f23ca/2590-7379-bio-40-s2-116-gf1.jpg

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