Department of Cardiovasculer Surgery, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Mimar Sinan Town, Emniyet Street, Yıldırım/BURSA, Turkey.
Department of Pulmonology, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
J Thromb Thrombolysis. 2021 Oct;52(3):759-765. doi: 10.1007/s11239-021-02405-7. Epub 2021 Mar 12.
Severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which has been considered a pandemic by the World Health Organization (WHO). Clinical manifestations of COVID-19 disease may differ, most cases are mild, but a significant minority of patients may develop moderate to severe respiratory symptoms, with the most severe cases requiring intensive care and/or mechanical ventilatory support. In this study, we aimed to identify validity of our modified scoring system for foreseeing the approach to the COVID-19 patient and the disease, the treatment plan, the severity of morbidity and even the risk of mortality from the clinician's point of view. In this single center study, we examined the patients hospitalized with the diagnosis of COVID-19 between 01/04/2020 and 01/06/2020, of the 228 patients who were between 20 and 90 years of age, and whose polymerase chain reaction (PCR) tests of nasal and pharyngeal swab samples were positive. We evaulated 228 (92 male and 136 female) PCR (+) patients. Univariate analysis showed that advanced age (p < 0.001), hemoglobin (p < 0.001), troponin-I (p < 0.001), C-reactive protein (CRP) (p < 0.001), fibrinogen (p < 0.001), HT (p = 0.01), CAD (p = 0.001), DM (p < 0.001), history of malignancy (p = 0.008), along with m-sPESI scores (p < 0.001) were significantly higher in patients that needed intensive care due to COVID-19 infection. In the multivariable logistic regression analysis, only the m-sPESI score higher than ≥ 2 was found to be highly significant in terms of indicating the need for ICU admission (AUC 0.948; 84.6% sensitivity and 94.6% specificity) (p < 0.001). With an increasing number of hospitalized patients, healthcare providers are confronting a deluge of lab results in the process of caring for COVID-19 patients. It is imperative to identify risk factors for mortality and morbidity development. The modified sPESI scoring system, which we put forward, is successful in predicting the course of the disease at the presentation of the patient with COVID-19 disease and predicting the need for intensive care with high specificity and sensitivity, can detect the need for intensive care with high specificity and sensitivity.
严重急性呼吸系统综合征相关冠状病毒 2（SARS-CoV-2）引起 2019 年冠状病毒病（COVID-19），世界卫生组织（WHO）已将其视为大流行。COVID-19 疾病的临床表现可能不同，大多数病例为轻症，但少数患者可能会出现中度至重度呼吸道症状，最严重的病例需要重症监护和/或机械通气支持。在这项研究中，我们旨在从临床医生的角度确定我们的改良评分系统对预见 COVID-19 患者及其疾病的走向、治疗计划、发病率严重程度甚至死亡率的有效性。在这项单中心研究中，我们研究了 2020 年 4 月 1 日至 2020 年 6 月 1 日期间因 COVID-19 住院的患者，这些患者年龄在 20 至 90 岁之间，其鼻和咽拭子样本的聚合酶链反应（PCR）检测结果为阳性。我们评估了 228 名（92 名男性和 136 名女性）PCR（+）患者。单因素分析显示，高龄（p<0.001）、血红蛋白（p<0.001）、肌钙蛋白 I（p<0.001）、C 反应蛋白（CRP）（p<0.001）、纤维蛋白原（p<0.001）、高血压（HT）（p=0.01）、冠心病（CAD）（p=0.001）、糖尿病（DM）（p<0.001）、恶性肿瘤史（p=0.008）以及改良的 m-sPESI 评分（p<0.001）在因 COVID-19 感染而需要重症监护的患者中明显更高。在多变量逻辑回归分析中，只有 m-sPESI 评分高于≥2 被发现与需要 ICU 入院高度相关（AUC 0.948；84.6%的敏感性和 94.6%的特异性）（p<0.001）。随着住院患者人数的增加，医疗保健提供者在照顾 COVID-19 患者的过程中面临着大量的实验室结果。确定死亡率和发病率发展的危险因素至关重要。我们提出的改良 sPESI 评分系统成功地预测了 COVID-19 患者疾病的发展过程，并具有高特异性和敏感性预测需要重症监护的能力，能够以高特异性和敏感性检测需要重症监护的需求。
