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高血压合并 COVID-19 的患者存在器官损伤加重的潜在风险。

COVID-19 patients with hypertension are at potential risk of worsened organ injury.

机构信息

Department of Clinical Pharmacy, Hubei No. 3 People's Hospital of Jianghan University (the Third People's Hospital of Hubei Province), Wuhan, China.

Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Wuhan, China.

出版信息

Sci Rep. 2021 Feb 12;11(1):3779. doi: 10.1038/s41598-021-83295-w.

Abstract

In less than 6 months, COVID-19 spread rapidly around the world and became a global health concern. Hypertension is the most common chronic disease in COVID-19 patients, but its impact on these patients has not been well described. In this retrospective study, 82 patients diagnosed with COVID-19 were enrolled, and epidemiological, demographic, clinical, laboratory, radiological and therapy-related data were analyzed and compared between COVID-19 patients with (29 cases) or without (53 cases) hypertension. The median age of the included patients was 60.5 years, and the cohort included 49 women (59.8%) and 33 (40.2%) men. Hypertension (31 [28.2%]) was the most common chronic illness, followed by diabetes (16 [19.5%]) and cardiovascular disease (15 [18.3%]). The most common symptoms were fatigue (55 [67.1%]), dry cough (46 [56.1%]) and fever ≥ 37.3 °C (46 [56.1%]). The median time from illness onset to positive RT-PCR test was 13.0 days (range 3-25 days). There were 6 deaths (20.7%) in the hypertension group and 5 deaths (9.4%) in the nonhypertension group, and more hypertensive patients with COVID-19 (8 [27.6%]) than nonhypertensive patients (2 [3.8%]) (P = 0.002) had at least one comorbid disease. Compared with nonhypertensive patients, hypertensive patients exhibited higher neutrophil counts, serum amyloid A, C-reactive protein, and NT-proBNP and lower lymphocyte counts and eGFR. Dynamic observations indicated more severe disease and poorer outcomes after hospital admission in the hypertension group. COVID-19 patients with hypertension have increased risks of severe inflammatory reactions, serious internal organ injury, and disease progression and deterioration.

摘要

在不到 6 个月的时间里,COVID-19 在全球范围内迅速传播,成为全球关注的健康问题。高血压是 COVID-19 患者最常见的慢性疾病,但它对这些患者的影响尚未得到充分描述。在这项回顾性研究中,共纳入了 82 例确诊 COVID-19 的患者,分析并比较了合并(29 例)或不合并(53 例)高血压的 COVID-19 患者的流行病学、人口统计学、临床、实验室、影像学和治疗相关数据。纳入患者的中位年龄为 60.5 岁,其中 49 例为女性(59.8%),33 例为男性(40.2%)。高血压(31 例,28.2%)是最常见的慢性疾病,其次是糖尿病(16 例,19.5%)和心血管疾病(15 例,18.3%)。最常见的症状是乏力(55 例,67.1%)、干咳(46 例,56.1%)和发热≥37.3℃(46 例,56.1%)。从发病到 RT-PCR 检测阳性的中位时间为 13.0 天(3-25 天)。高血压组有 6 例(20.7%)死亡,非高血压组有 5 例(9.4%)死亡,高血压合并 COVID-19 的患者(8 例,27.6%)比非高血压合并 COVID-19 的患者(2 例,3.8%)有更多的合并症(P=0.002)。与非高血压患者相比,高血压患者的中性粒细胞计数、血清淀粉样蛋白 A、C 反应蛋白和 NT-proBNP 更高,淋巴细胞计数和 eGFR 更低。动态观察表明,高血压组住院后疾病更严重,预后更差。COVID-19 合并高血压的患者发生严重炎症反应、严重内脏器官损伤、疾病进展和恶化的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81b3/7881102/972be9c7ff26/41598_2021_83295_Fig1_HTML.jpg

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