Department of Cardiology, The First Affiliated Hospital of Soochow University.
Department of Cardiology, Second Affiliated Hospital of Soochow University.
Medicine (Baltimore). 2021 Mar 19;100(11):e23656. doi: 10.1097/MD.0000000000023656.
Inflammation has been believed to contribute to coronavirus disease 2019 (COVID-19). Risk factors for death of COVID-19 pneumonia have not yet been well established.In this retrospective cohort study, we included the deceased patients in COVID-19 specialized ICU with laboratory-confirmed COVID-19 from Guanggu hospital area of Tongji Hospital from February 8th to March 30th. Demographic, clinical, laboratory, and outcome data were extracted from electronic medical records using a standard data collection form. We used Spearman rank correlation and Cox regression analysis to explore the risk factors associated with in-hospital death, especially the association between inflammatory cytokines and death.A total of 205 severe/critical COVID-19 pneumonia patients were admitted in the COVID-19 specialized ICU and 75 deceased patients were included in the final analysis. The median age of the deceasing patients was 70 years (IQR 65-79). The common symptoms were fever (78.9%), cough (70.4%), and expectoration (39.4%). The BNP and CRP levels were far beyond the normal reference range. In the Spearman rank correlation analysis, IL-8 was found to be significantly associated with the time from onset to death (rs= -0.30, P = .034) and that from admission to death (rs= -0.32, P = .019). Cox regression showed after adjusting age and sex, IL-8 levels were still significantly associated with the time from onset to death (P = .003) and that from admission to death (P = .01).IL-8 levels were associated with in-hospital death in severe/critical COVID-19 patients, which could help clinicians to identify patients with high risk of death at an early stage.
炎症被认为与 2019 年冠状病毒病(COVID-19)有关。COVID-19 肺炎死亡的危险因素尚未得到很好的确定。在这项回顾性队列研究中,我们纳入了 2 月 8 日至 3 月 30 日期间来自同济医院光谷院区 COVID-19 专科 ICU 的实验室确诊 COVID-19 死亡患者。从电子病历中提取人口统计学、临床、实验室和结局数据,并使用标准数据收集表。我们使用 Spearman 秩相关和 Cox 回归分析来探讨与住院死亡相关的危险因素,特别是炎症细胞因子与死亡之间的关系。共纳入 205 例重症/危重症 COVID-19 肺炎患者,其中 75 例死亡患者纳入最终分析。死亡患者的中位年龄为 70 岁(IQR 65-79)。常见症状为发热(78.9%)、咳嗽(70.4%)和咳痰(39.4%)。BNP 和 CRP 水平远远超出正常参考范围。Spearman 秩相关分析发现,IL-8 与发病至死亡时间(rs=-0.30,P=0.034)和入院至死亡时间(rs=-0.32,P=0.019)显著相关。Cox 回归显示,在校正年龄和性别后,IL-8 水平与发病至死亡时间(P=0.003)和入院至死亡时间(P=0.01)仍显著相关。IL-8 水平与重症/危重症 COVID-19 患者的院内死亡相关,这有助于临床医生在早期识别高死亡风险的患者。