First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan.
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, 390-8621, Japan.
J Infect Chemother. 2021 Dec;27(12):1706-1712. doi: 10.1016/j.jiac.2021.08.009. Epub 2021 Aug 13.
Risk factors for seriously ill coronavirus disease 19 (COVID-19) patients have been reported in several studies. However, to date, few studies have reported simple risk assessment tools for distinguishing patients becoming severely ill after initial diagnosis. Hence, this study aimed to develop a simple clinical risk nomogram predicting oxygenation risk in patients with COVID-19 at the first triage.
This retrospective study involved a chart review of the medical records of 84 patients diagnosed with COVID-19 between February 2020 and March 2021 at ten medical facilities. The patients were divided into requiring no oxygen therapy (non-severe group) and requiring oxygen therapy (severe group). Patient characteristics were compared between the two groups. We utilized univariate logistic regression analysis to confirm determinants of high risks of requiring oxygen therapy in patients with moderate COVID-19.
Thirty-five patients ware in severe group and forty-nine patients were in non-severe group. In comparison with patients in the non-severe group, patients in the severe group were significantly older with higher body mass index (BMI), and had a history of hypertension and diabetes. Serum blood urea nitrogen (BUN), lactic acid dehydrogenase (LDH), and C-reactive protein (CRP) levels were significantly higher in the severe group. Multivariate analysis showed that older age, higher BMI, and higher BUN levels were significantly associated with oxygen requirements.
This study demonstrated that age, BMI, and BUN were independent risk factors in the moderate-to-severe COVID-19 group. Elderly patients with higher BMI and BUN require close monitoring and early treatment initiation.
几项研究报告了导致严重的 2019 冠状病毒病(COVID-19)患者患病的风险因素。然而,迄今为止,很少有研究报告简单的风险评估工具来区分初始诊断后病情严重的患者。因此,本研究旨在开发一种简单的临床风险列线图,以预测 COVID-19 患者首次分诊时的氧合风险。
本回顾性研究纳入了 2020 年 2 月至 2021 年 3 月期间在十个医疗机构诊断为 COVID-19 的 84 例患者的病历回顾。患者分为无需氧疗(非重症组)和需要氧疗(重症组)。比较两组患者的特征。我们利用单因素 logistic 回归分析确认中度 COVID-19 患者需要氧疗的高风险的决定因素。
35 例患者为重症组,49 例患者为非重症组。与非重症组患者相比,重症组患者年龄较大,体重指数(BMI)较高,且有高血压和糖尿病病史。重症组患者的血清血尿素氮(BUN)、乳酸脱氢酶(LDH)和 C 反应蛋白(CRP)水平明显较高。多因素分析显示,年龄较大、BMI 较高和 BUN 水平较高与氧需求显著相关。
本研究表明,年龄、BMI 和 BUN 是 COVID-19 中重度患者的独立危险因素。年龄较大、BMI 较高和 BUN 较高的老年患者需要密切监测和早期治疗。