Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing210009, China.
Department of Clinical Sciences, Liverpool School of Tropical Medicine, LiverpoolL3 5QA, UK.
Epidemiol Infect. 2021 Jan 20;149:e31. doi: 10.1017/S0950268821000157.
This study was a retrospective multicentre cohort study of patients with coronavirus disease 2019 (COVID-19) diagnosed at 24 hospitals in Jiangsu province, China as of 15 March 2020. The primary outcome was the occurrence of acute respiratory failure during hospital stay. Of 625 patients, 56 (9%) had respiratory failure. Some selected demographic, epidemiologic, clinical and laboratory features as well as radiologic features at admission and treatment during hospitalisation were significantly different in patients with and without respiratory failure. The multivariate logistic analysis indicated that age (in years) (odds ratio [OR], 1.07; 95% confidence interval [CI]: 1.03-1.10; P = 0.0002), respiratory rate (breaths/minute) (OR, 1.23; 95% CI: 1.08-1.40; P = 0.0020), lymphocyte count (109/l) (OR, 0.18; 95% CI: 0.05-0.69; P = 0.0157) and pulmonary opacity score (per 5%) (OR, 1.38; 95% CI: 1.19-1.61; P < 0.0001) at admission were associated with the occurrence of respiratory failure. Older age, increased respiratory rate, decreased lymphocyte count and greater pulmonary opacity score at admission were independent risk factors of respiratory failure in patients with COVID-19. Patients having these risk factors need to be intensively managed during hospitalisation.
这项研究是一项回顾性多中心队列研究,纳入了截至 2020 年 3 月 15 日中国江苏省 24 家医院诊断的 2019 年冠状病毒病(COVID-19)患者。主要结局是住院期间发生急性呼吸衰竭。在 625 例患者中,有 56 例(9%)发生呼吸衰竭。有呼吸衰竭和无呼吸衰竭的患者在一些选定的人口统计学、流行病学、临床和实验室特征以及入院时的影像学特征和住院期间的治疗方面存在显著差异。多变量逻辑分析表明,年龄(岁)(比值比[OR],1.07;95%置信区间[CI]:1.03-1.10;P = 0.0002)、呼吸频率(次/分钟)(OR,1.23;95%CI:1.08-1.40;P = 0.0020)、淋巴细胞计数(109/l)(OR,0.18;95%CI:0.05-0.69;P = 0.0157)和入院时的肺部混浊评分(每 5%)(OR,1.38;95%CI:1.19-1.61;P < 0.0001)与呼吸衰竭的发生相关。入院时年龄较大、呼吸频率增加、淋巴细胞计数减少和肺部混浊评分较高是 COVID-19 患者发生呼吸衰竭的独立危险因素。具有这些危险因素的患者在住院期间需要加强管理。