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呼吸性碱中毒与新型冠状病毒肺炎患者预后的关系

Association Between Respiratory Alkalosis and the Prognosis of COVID-19 Patients.

作者信息

Wu Chenfang, Wang Guyi, Zhang Quan, Yu Bo, Lv Jianlei, Zhang Siye, Wu Guobao, Wu Shangjie, Zhong Yanjun

机构信息

Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.

Critical Care Medicine, The First Hospital of Changsha, Changsha, China.

出版信息

Front Med (Lausanne). 2021 Apr 26;8:564635. doi: 10.3389/fmed.2021.564635. eCollection 2021.

Abstract

The aim of the study was to describe the clinical characteristics of patients with or without respiratory alkalosis, and analyze the relationship of respiratory alkalosis and the outcome of adult coronavirus disease 2019 (COVID-19) patients. Clinical and laboratory data of adult COVID-19 patients in a single center in China, were retrospectively collected and analyzed. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between respiratory alkalosis and prognosis of COVID-19 patients. Of 230 adult COVID-19 patients, 66 patients (28.7%) had respiratory alkalosis on admission. Of 66 patients, the median age was 53 years old (range, 21-84 years), and 43 (65.2%) were female. Compared with those without respiratory alkalosis, patients with respiratory alkalosis were significantly older ( = 0.002), had a higher proportion of female ( = 0.004), and showed higher ratios of underlying diseases including hypertension ( = 0.023) and cardiovascular disease ( = 0.028). Moreover, they demonstrated higher proportion of severe events ( = 0.001). Patients with respiratory alkalosis had a higher possibility of developing severe events compared with those without respiratory alkalosis (Log Rank = 0.001). After adjusting for gender, age, and comorbidities, patients with respiratory alkalosis still showed significantly elevated risks of developing to severe cases (HR 2.445, 95% CI 1.307-4.571, = 0.005) using cox regression analyses. Respiratory alkalosis as a common acid-base disorder in COVID-19 patients, was associated with a higher risk of developing severe event.

摘要

本研究的目的是描述有或无呼吸性碱中毒患者的临床特征,并分析呼吸性碱中毒与成人2019冠状病毒病(COVID-19)患者预后的关系。回顾性收集并分析了中国某单中心成人COVID-19患者的临床和实验室数据。采用Kaplan-Meier(KM)曲线和Cox回归分析呼吸性碱中毒与COVID-19患者预后的相关性。在230例成人COVID-19患者中,66例(28.7%)入院时存在呼吸性碱中毒。在这66例患者中,中位年龄为53岁(范围21-84岁),43例(65.2%)为女性。与无呼吸性碱中毒的患者相比,有呼吸性碱中毒的患者年龄显著更大(P=0.002),女性比例更高(P=0.004),包括高血压(P=0.023)和心血管疾病(P=0.028)在内的基础疾病比例更高。此外,他们发生严重事件的比例更高(P=0.001)。与无呼吸性碱中毒的患者相比,有呼吸性碱中毒的患者发生严重事件的可能性更高(Log Rank P=0.001)。在调整性别、年龄和合并症后,使用Cox回归分析发现,有呼吸性碱中毒的患者发展为重症病例的风险仍显著升高(HR 2.445,95%CI 1.307-4.571,P=0.005)。呼吸性碱中毒作为COVID-19患者中常见的酸碱紊乱,与发生严重事件的较高风险相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0a/8107213/e672faa61442/fmed-08-564635-g0001.jpg

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