Suppr超能文献

纽约州北部一家三级社区医院中新冠病毒病危重症患者的临床特征与转归

Clinical characteristics and outcomes of critically ill patients with COVID-19 in a tertiary community hospital in upstate New York.

作者信息

Lenka Jyotirmayee, Chhabria Mamta S, Sharma Naman, Tan Bryan E-Xin, Boppana Leela Krishna Teja, Venugopal Sharini, Sondhi Damanpaul S

机构信息

Department of Medicine, Rochester General Hospital, Rochester, NY, USA.

Department of Pulmonary and Critical Care Medicine, Rochester General Hospital, Rochester, NY, USA.

出版信息

J Community Hosp Intern Med Perspect. 2020 Oct 29;10(6):491-500. doi: 10.1080/20009666.2020.1811070.

Abstract

: There are limited reports describing critically ill COVID-19 patients in the state of New York. : We conducted a retrospective analysis of 32 adult critically ill patients admitted to a community hospital in upstate New York, between 14 March and 12 April 2020. We collected demographic, laboratory, ventilator and treatment data, which were analyzed and clinical outcomes tabulated. : 32 patients admitted to the intensive care unit (ICU) were included, with mean (±SD) follow-up duration 21 ± 7 days. Mean (±SD) age was 62.2 ± 11.2 years, and 62.5% were men. 27 (84.4%) of patients had one or more medical co-morbidities. The mean (±SD) duration of symptoms was 6.6 (±4.4) days before presentation, with cough (81.3%), dyspnea (68.7%), and fever (65.6%) being the most common. 23 (71.9%) patients received invasive mechanical ventilation. 5 (15.6%) died, 11 (34.4%) were discharged home, and 16 (50%) remained hospitalized, 8 (25%) of which were still in ICU. Mean (±SD) length of ICU stay was 10.2 (±7.7) days, and mean (±SD) length of hospital stay was 14.8 (±7.7) days. : Majority of patients were of older age and with medical comorbidities. With adequate resource utilization, mortality of critically ill COVID-19 patients may not be as high as previously suggested. : ACE-i: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; ARDS: Acute Respiratory Distress Syndrome; BiPAP: Bilevel positive airway pressure; CABG: Coronary artery bypass graft; CFR: Case fatality rate; COVID-19: Coronavirus disease 19; CPAP: Continuous positive airway pressure; CRP: C - Reactive Protein; CT: Computed tomography; DVT: Deep vein thrombosis; ECMO: Extra Corporeal Membrane Oxygenation; ESICM: European Society of Intensive Care Medicine; FiO2: Fraction of inspired O2; HFNC: High Flow Nasal Cannula; HITF: Hypoxia-Inducible Transcription Factor; IBM: International Business Machines; ICU: Intensive Care Unit; IL: Interleukin; IMV: Invasive Mechanical Ventilation; IQR: Interquartile Range; ISTH: International Society of Thrombosis Hemostasis; NIV: Non Invasive Ventilation; NY: New York; PAI: Plasminogen activator inhibitor; PaO2: partial pressure of arterial oxygen; PCV: Pressure Control Ventilation; PEEP: Positive End Expiratory Pressure; RGH: Rochester General Hospital; RRH: Rochester Regional Health; RT-PCR: Reverse transcriptase polymerase chain reaction; RSV: Respiratory Syncytial virus; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SD: Standard Deviation; STEMI: ST segment elevation myocardial infarction; TNF: Tumor necrosis factor; USA: USA; VTE: Venous thromboembolism.

摘要

关于纽约州危重新型冠状病毒肺炎(COVID-19)患者的报道有限。

我们对2020年3月14日至4月12日期间收治于纽约州北部一家社区医院的32例成年危重症患者进行了回顾性分析。我们收集了人口统计学、实验室检查、呼吸机使用及治疗数据,并进行分析,将临床结局制成表格。

纳入了32例入住重症监护病房(ICU)的患者,平均(±标准差)随访时长为21±7天。平均(±标准差)年龄为62.2±11.2岁,62.5%为男性。27例(84.4%)患者有一种或多种合并症。出现症状至就诊的平均(±标准差)时长为6.6(±4.4)天,最常见的症状为咳嗽(81.3%)、呼吸困难(68.7%)和发热(65.6%)。23例(71.9%)患者接受了有创机械通气。5例(15.6%)死亡,11例(34.4%)出院回家,16例(50%)仍住院,其中8例(25%)仍在ICU。ICU平均(±标准差)住院时长为10.2(±7.7)天,平均(±标准差)住院总时长为14.8(±7.7)天。

大多数患者年龄较大且有合并症。通过充分利用资源,危重症COVID-19患者的死亡率可能不像之前报道的那么高。

ACE-i:血管紧张素转换酶抑制剂;ARB:血管紧张素受体阻滞剂;ARDS:急性呼吸窘迫综合征;BiPAP:双水平气道正压通气;CABG:冠状动脉旁路移植术;CFR:病死率;COVID-19:新型冠状病毒肺炎;CPAP:持续气道正压通气;CRP:C反应蛋白;CT:计算机断层扫描;DVT:深静脉血栓形成;ECMO:体外膜肺氧合;ESICM:欧洲重症医学学会;FiO2:吸入氧分数;HFNC:高流量鼻导管吸氧;HITF:缺氧诱导转录因子;IBM:国际商业机器公司;ICU:重症监护病房;IL:白细胞介素;IMV:有创机械通气;IQR:四分位数间距;ISTH:国际血栓与止血学会;NIV:无创通气;NY:纽约;PAI:纤溶酶原激活物抑制剂;PaO2:动脉血氧分压;PCV:压力控制通气;PEEP:呼气末正压;RGH:罗切斯特综合医院;RRH:罗切斯特地区卫生系统;RT-PCR:逆转录聚合酶链反应;RSV:呼吸道合胞病毒;SARS-CoV-2:严重急性呼吸综合征冠状病毒2;SD:标准差;STEMI:ST段抬高型心肌梗死;TNF:肿瘤坏死因子;USA:美国;VTE:静脉血栓栓塞症

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b519/7599024/437d04f2efc9/ZJCH_A_1811070_F0001_OC.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验