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2019年冠状病毒病不同疾病严重程度或年龄范围的患者:一项临床特征与预后的单中心研究

Corona Virus Disease 2019 patients with different disease severity or age range: A single-center study of clinical features and prognosis.

作者信息

Ren Lingyun, Yao Dan, Cui Zuowei, Chen Shanshan, Yan Hong

机构信息

Department of Anesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.

出版信息

Medicine (Baltimore). 2020 Dec 4;99(49):e22899. doi: 10.1097/MD.0000000000022899.

Abstract

This study aimed to describe clinical characteristics and prognosis of Corona Virus Disease 2019 (COVID-19) patients, and to compare these features among COVID-19 patients with different disease severity or age range.Totally, 129 COVID-19 patients were retrospectively enrolled, and the information about demographics, comorbidities, medical histories, clinical symptoms, and laboratory findings at the time of hospital admission were collected. Meanwhile, their clinical outcomes were recorded. According to the fourth version of the guidelines on the Diagnosis and Treatment of COVID-19 by the National Health Commission of China, patients were divided into subgroups according to disease severity (moderate and severe/critical) or age (<40 years, 40-64 years and ≥65 years).In total patients, the most common clinical symptoms were fever and cough (all incidences over 50%). Other common clinical symptoms included tiredness/anorexia, shortness of breath, dyspnea, aching pain, expectoration, diarrhea, shivering, and nausea/vomiting. The mortality rate was 5.4%, and the median value of hospital stay was 16.0 (11.0-23.0) days. Subgroup analyses disclosed that severe/critical patients exhibited increased neutrophil count, neutrophils, C-reactive protein, calcitonin, alpha-hydroxybutyric dehydrogenase, lactate dehydrogenase, aspartate aminotransferase, gamma-glutamyl transferase, creatinine, and D-dimer levels, and more deaths compared with that in moderate patients. Regarding age, it correlated with more common fever, higher levels of red blood cell, neutrophil count, lymphocyte count, neutrophils, red cell volume distribution width standard deviation-coefficient of variation, calcitonin, alpha-hydroxybutyric dehydrogenase, Creatine Kinase, aspartate aminotransferase, gamma-glutamyl transferase, and D-dimer, raised death rate and prolonged hospital stay.Our findings provide valuable evidence regarding clinical characteristics and prognosis of COVID-19 patients to help with the understanding of the disease and prognosis improvement.

摘要

本研究旨在描述2019冠状病毒病(COVID-19)患者的临床特征和预后,并比较不同疾病严重程度或年龄范围的COVID-19患者的这些特征。总共回顾性纳入了129例COVID-19患者,收集了入院时的人口统计学、合并症、病史、临床症状和实验室检查结果等信息。同时,记录了他们的临床结局。根据中国国家卫生健康委员会《新型冠状病毒肺炎诊疗方案(试行第四版)》,患者按疾病严重程度(普通型和重型/危重型)或年龄(<40岁、40-64岁和≥65岁)分为亚组。在全部患者中,最常见的临床症状是发热和咳嗽(发生率均超过50%)。其他常见临床症状包括乏力/厌食、气短、呼吸困难、疼痛、咳痰、腹泻、寒战和恶心/呕吐。死亡率为5.4%,住院时间中位数为16.0(11.0-23.0)天。亚组分析显示,重型/危重型患者中性粒细胞计数、中性粒细胞比例、C反应蛋白、降钙素、α-羟丁酸脱氢酶、乳酸脱氢酶、天门冬氨酸氨基转移酶、γ-谷氨酰转移酶、肌酐和D-二聚体水平升高,且死亡人数多于普通型患者。在年龄方面,年龄越大发热越常见,红细胞、中性粒细胞计数、淋巴细胞计数、中性粒细胞比例、红细胞体积分布宽度标准差-变异系数、降钙素、α-羟丁酸脱氢酶、肌酸激酶、天门冬氨酸氨基转移酶、γ-谷氨酰转移酶和D-二聚体水平越高,死亡率越高,住院时间越长。我们的研究结果为COVID-19患者的临床特征和预后提供了有价值的证据,有助于了解该疾病并改善预后。

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