肥胖和吸烟是 COVID-19 患者接受有创机械通气的危险因素：一项回顾性、观察性队列研究。
Obesity and smoking as risk factors for invasive mechanical ventilation in COVID-19: A retrospective, observational cohort study.
机构信息
Division of Pulmonary and Critical Care, Department of Medicine, UCLA Medical Center, Los Angeles, CA, United States of America.
Department of Medicine, UCLA Medical Center, Los Angeles, CA, United States of America.
出版信息
PLoS One. 2020 Dec 22;15(12):e0238552. doi: 10.1371/journal.pone.0238552. eCollection 2020.
PURPOSE
To describe the trajectory of respiratory failure in COVID-19 and explore factors associated with risk of invasive mechanical ventilation (IMV).
MATERIALS AND METHODS
A retrospective, observational cohort study of 112 inpatient adults diagnosed with COVID-19 between March 12 and April 16, 2020. Data were manually extracted from electronic medical records. Multivariable and Univariable regression were used to evaluate association between baseline characteristics, initial serum markers and the outcome of IMV.
RESULTS
Our cohort had median age of 61 (IQR 45-74) and was 66% male. In-hospital mortality was 6% (7/112). ICU mortality was 12.8% (6/47), and 18% (5/28) for those requiring IMV. Obesity (OR 5.82, CI 1.74-19.48), former (OR 8.06, CI 1.51-43.06) and current smoking status (OR 10.33, CI 1.43-74.67) were associated with IMV after adjusting for age, sex, and high prevalence comorbidities by multivariable analysis. Initial absolute lymphocyte count (OR 0.33, CI 0.11-0.96), procalcitonin (OR 1.27, CI 1.02-1.57), IL-6 (OR 1.17, CI 1.03-1.33), ferritin (OR 1.05, CI 1.005-1.11), LDH (OR 1.57, 95% CI 1.13-2.17) and CRP (OR 1.13, CI 1.06-1.21), were associated with IMV by univariate analysis.
CONCLUSIONS
Obesity, smoking history, and elevated inflammatory markers were associated with increased need for IMV in patients with COVID-19.
目的
描述 COVID-19 患者呼吸衰竭的轨迹，并探讨与有创机械通气（IMV）风险相关的因素。
材料和方法
这是一项回顾性、观察性队列研究，纳入了 2020 年 3 月 12 日至 4 月 16 日期间 112 名住院的成年 COVID-19 患者。数据从电子病历中手动提取。采用多变量和单变量回归评估基线特征、初始血清标志物与 IMV 结局之间的关系。
结果
本队列的中位年龄为 61（IQR 45-74）岁，男性占 66%（71/112）。院内死亡率为 6%（7/112）。入住 ICU 的患者死亡率为 12.8%（6/47），需要 IMV 的患者死亡率为 18%（5/28）。肥胖（OR 5.82，CI 1.74-19.48）、既往（OR 8.06，CI 1.51-43.06）和当前吸烟状态（OR 10.33，CI 1.43-74.67）与多变量分析调整年龄、性别和高患病率合并症后，与 IMV 相关。初始绝对淋巴细胞计数（OR 0.33，CI 0.11-0.96）、降钙素原（OR 1.27，CI 1.02-1.57）、IL-6（OR 1.17，CI 1.03-1.33）、铁蛋白（OR 1.05，CI 1.005-1.11）、乳酸脱氢酶（OR 1.57，95%CI 1.13-2.17）和 C 反应蛋白（OR 1.13，CI 1.06-1.21）在单变量分析中与 IMV 相关。
结论
肥胖、吸烟史和升高的炎症标志物与 COVID-19 患者对 IMV 的需求增加相关。
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