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刚果民主共和国金沙萨尼加利马公立医院住院的 COVID-19 患者的临床特征:一项回顾性队列研究。

Clinical characteristics of COVID-19 patients hospitalized at Clinique Ngaliema, a public hospital in Kinshasa, in the Democratic Republic of Congo: A retrospective cohort study.

机构信息

Clinique Ngaliema, Kinshasa, République Démocratique du Congo.

Département de Médecine Tropicale, Université de Kinshasa, Kinshasa, République Démocratique du Congo.

出版信息

PLoS One. 2020 Dec 18;15(12):e0244272. doi: 10.1371/journal.pone.0244272. eCollection 2020.

Abstract

OBJECTIVES

To describe the clinical characteristics of patients infected with SARS-CoV-2 at Clinique Ngaliema, a public hospital, in Kinshasa, in the Democratic Republic of Congo (DRC).

METHODS

This retrospective study analyzed medical records including socio-demographics, past medical history, clinical manifestation, comorbidities, laboratory data, treatment and disease outcome of 160 hospitalized COVID-19 patients, with confirmed result of SARS-CoV-2 viral infection.

RESULTS

The median age of patients was 54 years (IQR: 38-64), and there was no significant gender difference (51% of male). The most common comorbidities were hypertension (55 [34%]), diabetes (31 [19%]) and obesity (13 [8%]). Fever (93 [58%]), cough (92 [57%]), fatigue (87 [54%]), shortness of breath (72 [45%]) and myalgia (33 [21%]) were the most common symptoms, upon admission. Patients were categorized into mild (92 [57%]), moderate (19 [12%]) and severe (49 [31%]). Severe patients were older and were more likely to have comorbidities, compared to mild ones. The majority of patients (92% [147 of 160]) patients received hydroxychloroquine or chloroquine phosphate. Regression model revealed that older age, lower SpO2, higher heart rate and elevated AST at admission were all risk factors associated with in-hospital death. The prevalence of COVID-19 and malaria co-infection was 0.63% and 70 (44%) of all patients received antimalarial treatment before hospitalization.

CONCLUSION

Our findings indicated that the epidemiological and clinical feature of COVID-19 patients in Kinshasa are broadly similar to previous reports from other settings. Older age, lower SpO2, tachycardia, and elevated AST could help to identify patients at higher risk of death at an early stage of the illness. Plasmodium spp co-infection was not common in hospitalized COVID-19 patients.

摘要

目的

描述在刚果民主共和国(DRC)金沙萨的公立医院 Ngaliema 诊所感染 SARS-CoV-2 的患者的临床特征。

方法

这项回顾性研究分析了 160 名住院 COVID-19 患者的病历,包括社会人口统计学、既往病史、临床表现、合并症、实验室数据、治疗和疾病结局,这些患者的 SARS-CoV-2 病毒感染均得到确认。

结果

患者的中位年龄为 54 岁(IQR:38-64),且无明显的性别差异(51%为男性)。最常见的合并症是高血压(55 [34%])、糖尿病(31 [19%])和肥胖症(13 [8%])。入院时最常见的症状是发热(93 [58%])、咳嗽(92 [57%])、乏力(87 [54%])、呼吸急促(72 [45%])和肌痛(33 [21%])。患者被分为轻症(92 [57%])、中度(19 [12%])和重症(49 [31%])。与轻症患者相比,重症患者年龄更大,且更有可能合并症。大多数患者(92% [147 例/160 例])接受了羟氯喹或磷酸氯喹治疗。回归模型显示,入院时年龄较大、SpO2 较低、心率较快和 AST 升高均为与院内死亡相关的危险因素。COVID-19 和疟疾合并感染的患病率为 0.63%,且所有患者中有 70 例(44%)在住院前接受了抗疟治疗。

结论

我们的研究结果表明,金沙萨 COVID-19 患者的流行病学和临床特征与其他地区的先前报告大致相似。年龄较大、SpO2 较低、心动过速和 AST 升高可能有助于在疾病早期识别出死亡风险较高的患者。在住院 COVID-19 患者中,疟原虫合并感染并不常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9165/7748279/b4f19ab1beb3/pone.0244272.g001.jpg

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