Vaquero-Roncero L M, Sánchez-Barrado E, Escobar-Macias D, Arribas-Pérez P, González de Castro R, González-Porras J R, Sánchez-Hernandez M V
Departamento de Anestesiología y Reanimación, Hospital Universitario de Salamanca-IBSAL, Departamento de Medicina, Universidad de Salamanca, Salamanca, España.
Departamento de Anestesiología y Reanimación, Hospital Universitario de León, Universidad de León, León, España.
Rev Esp Anestesiol Reanim. 2021 Nov;68(9):513-522. doi: 10.1016/j.redar.2020.11.014. Epub 2021 Jan 16.
To identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.
An approved, observational, retrospective study was conducted between March 15 to April 15, 2020. 150 adult patients aged less than 75 with Charlson comorbidity index ≤ 6 diagnosed with COVID-19 pneumonia were included. Seventy-five patients were randomly selected from those admitted to the critical care units (critical care group [CG]) and seventy-five hospitalized patients who did not require critical care (non-critical care group [nCG]) represent the control group. One additional cohort of hospitalized patients with COVID-19 were used to validate the score.
Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 [1.009-1.101]; = .0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 [1.389-2.590]; < .0001), both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA < .05). The AUC-ROC for the validation cohort was 0.89 (0.82-0.95) ( > 0.05 vs AUC-ROC development).
Patients COVID-19 presenting at admission SOFA score ≥ 2 combined with CRP ≥ 9,1 mg/mL could be at high risk to require critical care.
确定新冠肺炎肺炎患者入院时预测其是否需要重症监护的潜在标志物。
于2020年3月15日至4月15日进行了一项经批准的观察性回顾性研究。纳入150例年龄小于75岁、Charlson合并症指数≤6且诊断为新冠肺炎肺炎的成年患者。从入住重症监护病房的患者中随机选取75例（重症监护组[CG]），另外75例无需重症监护的住院患者（非重症监护组[nCG]）作为对照组。使用另一组新冠肺炎住院患者来验证该评分。
多变量回归显示，入院时C反应蛋白（CRP）升高（比值比1.052[1.009 - 1.101]；P = 0.0043）和序贯器官衰竭评估（SOFA）评分较高（1.968[1.389 - 2.590]；P < 0.0001）与住院期间需要重症监护的几率增加相关。联合模型的AUC - ROC为0.83（0.76 - 0.90）（与SOFA的AUC - ROC相比，P < 0.05）。验证队列的AUC - ROC为0.89（0.82 - 0.95）（与开发队列的AUC - ROC相比，P > 0.05）。
入院时SOFA评分≥2且CRP≥9.1mg/mL的新冠肺炎患者可能有较高的重症监护需求风险。
