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中国江苏重症 COVID-19 成年患者的临床特征和危险因素:一项多中心回顾性研究。

Clinical features and risk factors for severe-critically ill COVID-19 adult patients in Jiangsu, China: A multiple-centered, retrospective study.

机构信息

Department of Respiratory and Critical Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing.

Department of Respiratory and Critical Medicine, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu.

出版信息

Medicine (Baltimore). 2021 Feb 5;100(5):e24332. doi: 10.1097/MD.0000000000024332.

Abstract

Coronavirus disease 2019 (COVID-19) becomes a global pandemic in 2020. Early identification of severe ill patients is a top priority for clinicians. We aimed to describe clinical features and risk factors of severe-critically ill patients with COVID-19 in Jiangsu Province.This multi-centered retrospective study collected the information of 631 laboratory-confirmed COVID-19 patients hospitalized at 28 authorized hospitals in Jiangsu province from January 23, 2019 to March 13, 2020.A total of 583 adult patients with laboratory-confirmed COVID-19 were enrolled for final analysis, including 84 severe-critically ill patients and 499 mild-moderate patients. Median age of the severe-critically ill patients was 57.0 years old (interquartile range, 49.0-65.8), and 50 (59.5%) were males. Multisystemic laboratory abnormalities were observed on admission for severe-critically ill patients. These patients showed more noticeable radiologic abnormalities and more coexisting health issues as compared to the mild-moderate patients. Most of the severe-critically ill COVID-19 patients became deteriorated in 2 weeks after diagnosis. Age, D-dimer, and lymphocytes were independently associated with the progression of severe-critically illness.Older age, higher D-dimer levels and less lymphocyte counts on admission are potential risk factors for COVID-19 patients to develop into severe and critically illness.

摘要

2020 年,新型冠状病毒病(COVID-19)成为全球大流行疾病。早期识别重症患者是临床医生的首要任务。本研究旨在描述江苏省 COVID-19 重症危重症患者的临床特征和危险因素。

这项多中心回顾性研究收集了 2019 年 1 月 23 日至 2020 年 3 月 13 日江苏省 28 家授权医院收治的 631 例实验室确诊 COVID-19 患者的信息。共纳入 583 例实验室确诊 COVID-19 成年患者进行最终分析,包括 84 例重症危重症患者和 499 例轻症中度患者。重症危重症患者的中位年龄为 57.0 岁(四分位距,49.0-65.8),男性 50 例(59.5%)。重症危重症患者入院时存在多种系统性实验室异常。与轻症中度患者相比,这些患者的影像学异常更为明显,并存的健康问题也更多。大多数重症 COVID-19 患者在诊断后 2 周内病情恶化。年龄、D-二聚体和淋巴细胞与重症危重症的进展独立相关。

入院时年龄较大、D-二聚体水平较高和淋巴细胞计数较低是 COVID-19 患者发展为重症和危重症的潜在危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a88d/7870254/82e713e462a6/medi-100-e24332-g001.jpg

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