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2019 年冠状病毒病相关死亡率的危险因素和最佳治疗方案:一项回顾性研究。

Risk Factors of Coronavirus Disease 2019-Related Mortality and Optimal Treatment Regimens: A Retrospective Study.

机构信息

Department of Pediatrics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China (mainland).

Cancer Prevention Office, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China (mainland).

出版信息

Med Sci Monit. 2021 Feb 11;27:e926751. doi: 10.12659/MSM.926751.

Abstract

BACKGROUND Coronavirus disease 2019 (COVID-19) is spreading rapidly worldwide, and scientists are trying to find a way to overcome the disease. We explored the risk factors that influence patient outcomes, including treatment regimens, which can provide a reference for further treatment. MATERIAL AND METHODS A retrospective cohort study analysis was performed using data from 97 patients with COVID-19 who visited Wuhan Union Hospital from February 2020 to March 2020. We collected data on demographics, comorbidities, clinical manifestations, laboratory tests, treatment methods, outcomes, and complications. Patients were divided into a recovered group and a deceased group. We compared the differences between the 2 groups and analyzed risk factors influencing the treatment effect. RESULTS Seventy-six patients recovered and 21 died. The average age and body mass index (BMI) of the deceased group were significantly higher than those of the recovered group (69.81±6.80 years vs 60.79±11.28 years, P<0.001 and 24.95±3.14 kg/m² vs 23.09±2.97 kg/m², P=0.014, respectively). The combination of antiviral drugs and supportive therapy appears to be associated with the lowest mortality (P<0.05). Multivariate Cox regression analysis revealed that age, BMI, H-CRP, shock, and acute respiratory distress syndrome (ARDS) were independent risk factors for patients with COVID-19 (P<0.05). CONCLUSIONS Elderly patients and those with a high BMI, as well as patients who experience shock and ARDS, may have a higher risk of death from COVID-19. The combination of antiviral drugs and supportive therapy appears to be associated with lower mortality, although further research is needed.

摘要

背景

2019 年冠状病毒病(COVID-19)在全球范围内迅速传播,科学家们正在努力寻找克服该疾病的方法。我们探讨了影响患者预后的危险因素,包括治疗方案,为进一步治疗提供参考。

材料和方法

使用 2020 年 2 月至 3 月期间来自武汉协和医院的 97 例 COVID-19 患者的数据进行回顾性队列研究分析。我们收集了人口统计学、合并症、临床表现、实验室检查、治疗方法、结局和并发症的数据。将患者分为康复组和死亡组。我们比较了两组之间的差异,并分析了影响治疗效果的危险因素。

结果

76 例患者康复,21 例死亡。死亡组的平均年龄和体重指数(BMI)明显高于康复组(69.81±6.80 岁比 60.79±11.28 岁,P<0.001 和 24.95±3.14 kg/m²比 23.09±2.97 kg/m²,P=0.014)。抗病毒药物联合支持治疗似乎与最低死亡率相关(P<0.05)。多变量 Cox 回归分析显示,年龄、BMI、H-CRP、休克和急性呼吸窘迫综合征(ARDS)是 COVID-19 患者的独立危险因素(P<0.05)。

结论

老年患者和 BMI 较高的患者,以及出现休克和 ARDS 的患者,COVID-19 死亡风险可能更高。抗病毒药物联合支持治疗似乎与较低的死亡率相关,但需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f92a/7885294/e4b07f17ce66/medscimonit-27-e926751-g001.jpg

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