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韩国大邱市 COVID-19 重症患者的临床特征和预后因素:一项多中心回顾性研究。

Clinical features and prognostic factors of critically ill patients with COVID-19 in Daegu, South Korea: A multi-center retrospective study.

机构信息

Division of Pulmonary and Critical Care Medicine, Daegu Catholic university hospital.

Department of Internal Medicine, School of Medicine, Kyungpook National University.

出版信息

Medicine (Baltimore). 2021 Feb 19;100(7):e24437. doi: 10.1097/MD.0000000000024437.

Abstract

To describe the clinical and demographic characteristics of critically ill patients with COVID-19 in Daegu, South Korea, and to explore the risk factors for in-hospital mortality in these patients.Retrospective cohort study of 110 critically ill patients with COVID-19 admitted to the ICU in Daegu, South Korea, between February 18 and April 5, 2020. The final date of follow-up was April 20, 2020.A total of 110 patient medical records were reviewed. The median age was 71 years (interquartile range [IQR] = 63-78 years). During the study period, 47 patients (42.7%) died in the hospital. The most common SARS-CoV-2 infection related complication was acute respiratory distress syndrome (ARDS) in 95 patients (86.4%). Of the 79 patients (71.8%) who received invasive mechanical ventilation, 46 (58.2%) received neuromuscular blockade injection, and 19 (24.1%) received ECMO treatment. All patients received antibiotic injection, 99 patients (90%) received hydroxychloroquine, 96 patients (87.3%) received lopinavir-ritonavir antiviral medication, and 14 patients (12.7%) received other antiviral agents, including darunavir-cobicistat and emtricitabine-tenofovir. In the multivariable logistic regression model, the odds ratio of in-hospital death was higher with APACHE II score (OR = 1.126; 95% CI = 1.014-1.252; P  = .027).The in-hospital mortality rate of critically ill patients with COVID-19 was approximately 40%. Higher APACHE II score at admission was an independent risk factor for death in these patients.

摘要

描述韩国大邱市 COVID-19 重症患者的临床和人口统计学特征,并探讨这些患者住院死亡率的危险因素。

这是一项回顾性队列研究,纳入了 2020 年 2 月 18 日至 4 月 5 日期间在韩国大邱市 ICU 收治的 110 例 COVID-19 重症患者。随访的最终日期为 2020 年 4 月 20 日。共回顾了 110 例患者的病历。中位年龄为 71 岁(四分位距 [IQR] = 63-78 岁)。研究期间,47 例(42.7%)患者在医院死亡。最常见的 SARS-CoV-2 感染相关并发症是 95 例(86.4%)患者的急性呼吸窘迫综合征(ARDS)。在接受有创机械通气的 79 例患者中(71.8%),46 例(58.2%)接受了神经肌肉阻滞剂注射,19 例(24.1%)接受了 ECMO 治疗。所有患者均接受了抗生素注射,99 例(90%)接受了羟氯喹,96 例(87.3%)接受了洛匹那韦-利托那韦抗病毒药物治疗,14 例(12.7%)接受了其他抗病毒药物治疗,包括达芦那韦-考比司他和恩曲他滨-替诺福韦。在多变量逻辑回归模型中,入院时的急性生理与慢性健康状况评分(APACHE II 评分)越高,住院死亡的比值比(OR)越高(OR = 1.126;95%CI = 1.014-1.252;P = 0.027)。COVID-19 重症患者的院内死亡率约为 40%。入院时较高的 APACHE II 评分是这些患者死亡的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fc2/7899898/560eec2d3072/medi-100-e24437-g001.jpg

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