Lu Yanjiao, Huang Zhenli, Wang Meijia, Tang Kun, Wang Shanshan, Gao Pengfei, Xie Jungang, Wang Tao, Zhao Jianping
Department of Respiratory and Critical Care Medicine, National Clinical Research Center of Respiratory Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, China.
Ann Clin Microbiol Antimicrob. 2021 Jan 6;20(1):3. doi: 10.1186/s12941-020-00412-9.
Little is yet known whether pathogenesis of COVID-19 is different between young and elder patients. Our study aimed to investigate the clinical characteristics and provide predictors of mortality for young adults with severe COVID-19.
A total of 77 young adults with confirmed severe COVID-19 were recruited retrospectively at Tongji Hospital. Clinical characteristics, laboratory findings, treatment and outcomes were obtained from electronic medical records. The prognostic effects of variables were analyzed using logistic regression model.
In this retrospective cohort, non-survivors showed higher incidence of dyspnea and co-existing laboratory abnormalities, compared with young survivals in severe COVID-19. Multivariate logistic regression analysis showed that lymphopenia, elevated level of d-dimer, hypersensitive cardiac troponin I (hs-CTnI) and high sensitivity C-reactive protein (hs-CRP) were independent predictors of mortality in young adults with severe COVID-19. Further analysis showed that severely young adults with two or more factors abnormalities above would be more prone to death. The similar predictive effect of above four factors had been observed in all-age patients with severe COVID-19.
Lymphopenia, elevated level of d-dimer, hs-CTnI and hs-CRP predicted clinical outcomes of young adults with severe COVID-19.
关于新型冠状病毒肺炎（COVID-19）在年轻和老年患者中的发病机制是否存在差异，目前所知甚少。我们的研究旨在调查重症COVID-19年轻成人患者的临床特征，并提供死亡率的预测指标。
回顾性招募了77例确诊为重症COVID-19的年轻成人患者，这些患者均来自同济医院。从电子病历中获取临床特征、实验室检查结果、治疗情况及预后。采用逻辑回归模型分析各变量的预后影响。
在这个回顾性队列研究中，与重症COVID-19年轻幸存者相比，非幸存者呼吸困难及合并实验室异常的发生率更高。多因素逻辑回归分析显示，淋巴细胞减少、D-二聚体水平升高、超敏心肌肌钙蛋白I（hs-CTnI）及高敏C反应蛋白（hs-CRP）升高是重症COVID-19年轻成人患者死亡的独立预测因素。进一步分析表明，上述两项或更多因素异常的重症年轻成人患者更容易死亡。在所有年龄段的重症COVID-19患者中均观察到上述四个因素具有相似的预测作用。
淋巴细胞减少、D-二聚体水平升高、hs-CTnI及hs-CRP可预测重症COVID-19年轻成人患者的临床预后。
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