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COVID-19 患者重症和危重症的危险因素:综述。

Risk factors for severe and critically ill COVID-19 patients: A review.

机构信息

Department of Allergology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Zurich, Switzerland.

出版信息

Allergy. 2021 Feb;76(2):428-455. doi: 10.1111/all.14657. Epub 2020 Dec 4.

Abstract

The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID-19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID-19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines such as interleukin (IL)-6, IL-1β, Krebs von den Lungen-6 (KL-6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID-19.

摘要

2019 年冠状病毒病(COVID-19)大流行是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的,它造成了前所未有的全球社会和经济影响,并导致了大量死亡。在 COVID-19 发展为严重和危急阶段的过程中,许多危险因素已被确定,包括年龄较大、男性、高血压、糖尿病、肥胖、慢性肺部疾病、心脏、肝脏和肾脏疾病、肿瘤、明显的临床免疫缺陷、局部免疫缺陷,如早期 I 型干扰素分泌能力和妊娠。可能的并发症包括急性肾损伤、凝血障碍、血栓栓塞。淋巴细胞减少和嗜酸性粒细胞减少是 COVID-19 的实验室指标。监测疾病进展的实验室参数包括乳酸脱氢酶、降钙素原、高敏 C 反应蛋白、白细胞介素(IL)-6、IL-1β、Krebs von den Lungen-6(KL-6)和铁蛋白。细胞因子风暴的发展和广泛的胸部计算机断层扫描成像模式是疾病严重的指标。此外,社会经济地位、饮食、生活方式、地理差异、种族、暴露的病毒载量、治疗开始的天数以及医疗保健质量也被报道会影响个体的结果。在这篇综述中,我们强调了 COVID-19 严重程度的危险因素的科学证据。

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