Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Med Virol. 2021 May;93(5):2908-2917. doi: 10.1002/jmv.26771. Epub 2021 Feb 23.
The aim is to explore the relation between inflammation-associated factors and in-hospital mortality and investigate which factor is an independent predictor of in-hospital death in patients with coronavirus disease-2019. This study included patients with coronavirus disease-2019, who were hospitalized between February 9, 2020, and March 30, 2020. Univariate Cox regression analysis and least absolute shrinkage and selection operator regression (LASSO) were used to select variables. Multivariate Cox regression analysis was applied to identify independent risk factors in coronavirus disease-2019. A total of 1135 patients were analyzed during the study period. A total of 35 variables were considered to be risk factors after the univariate regression analysis of the clinical characteristics and laboratory parameters (p < .05), and LASSO regression analysis screened out seven risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were myoglobin (HR, 5.353; 95% CI, 2.633-10.882; p < .001), C-reactive protein (HR, 2.063; 95% CI, 1.036-4.109; p = .039), neutrophil count (HR, 2.015; 95% CI, 1.154-3.518; p = .014), interleukin 6 (Il-6; HR, 9.753; 95% CI, 2.952-32.218; p < .001), age (HR, 2.016; 95% CI, 1.077-3.773; p = .028), and international normalized ratio (HR, 2.595; 95% CI, 1.412-4.769; p = .002). Our results suggested that inflammation-associated factors were significantly associated with in-hospital mortality in coronavirus disease-2019 patients. C-reactive protein, neutrophil count, and interleukin 6 were independent factors for predicting in-hospital mortality and had a better independent predictive ability. We believe these findings may allow early identification of the patients at high risk for death, and can also assist in better management of these patients.
目的是探讨与炎症相关的因素与住院患者病死率之间的关系,并探讨在 2019 冠状病毒病患者中,哪种因素是住院死亡的独立预测因子。本研究纳入了 2020 年 2 月 9 日至 2020 年 3 月 30 日期间住院的 2019 冠状病毒病患者。采用单因素 Cox 回归分析和最小绝对收缩和选择算子回归(LASSO)选择变量。多因素 Cox 回归分析用于确定 2019 冠状病毒病的独立危险因素。研究期间共分析了 1135 例患者。在对临床特征和实验室参数进行单因素回归分析后(p<0.05),共考虑了 35 个变量作为危险因素,LASSO 回归分析筛选出 7 个进一步研究的危险因素。多因素 Cox 回归分析揭示了 6 个独立的危险因素,分别是肌红蛋白(HR,5.353;95%CI,2.633-10.882;p<0.001)、C 反应蛋白(HR,2.063;95%CI,1.036-4.109;p=0.039)、中性粒细胞计数(HR,2.015;95%CI,1.154-3.518;p=0.014)、白细胞介素 6(IL-6;HR,9.753;95%CI,2.952-32.218;p<0.001)、年龄(HR,2.016;95%CI,1.077-3.773;p=0.028)和国际标准化比值(HR,2.595;95%CI,1.412-4.769;p=0.002)。研究结果表明,与炎症相关的因素与 2019 冠状病毒病患者的住院病死率显著相关。C 反应蛋白、中性粒细胞计数和白细胞介素 6 是预测住院死亡率的独立因素,具有更好的独立预测能力。我们相信这些发现可以帮助早期识别死亡风险较高的患者,并有助于更好地管理这些患者。