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墨西哥SARS-CoV-2肺炎住院患者回顾性队列中的神经学表现及预后:风险概况设计

Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile.

作者信息

García Silvia, Cuatepotzo-Burgos Francisco Manuel, Toledo-Lozano Christian Gabriel, Balderrama-Soto Adriana, Alcaraz-Estrada Sofía Lizeth, Montiel-López Luis, De la Vega-Bravo Alberto Hilarión, Mondragón-Terán Paul, Santosbeña-Lagunes Maribel, Escarela-Serrano Maricela, Rodríguez-Martínez Celia Mireya, Méndez-Vidrio María Del Carmen, Muñoz-López Sandra, Merino-Rajme José Alfredo, Rodríguez-Briseño Rodrigo Alberto, Cerda-Téllez Fidel, Coral-Vázquez Ramón Mauricio, Sauri-Suárez Sergio, Quiñonez-Aguilar Sandra, Pineda-Juárez Juan Antonio, Suárez-Cuenca Juan Antonio

机构信息

Department of Clinical Research, Centro Médico Nacional "20 de Noviembre", ISSSTE, Mexico City 03229, Mexico.

Multidisciplinary Care Team for Patients with COVID-19 of Centro Médico Nacional "20 de Noviembre", ISSSTE, Mexico City 03229, Mexico.

出版信息

Healthcare (Basel). 2021 Nov 4;9(11):1501. doi: 10.3390/healthcare9111501.

Abstract

We analyzed the neurological manifestations in Mexican patients hospitalized with pneumonia due to COVID-19 and investigated the association between demographic, clinical, and biochemical variables and outcomes, including death. A retrospective, analytical study was conducted using the electronic records of patients hospitalized between 1 April 2020 and 30 September 2020. Records of 1040 patients were analyzed: 31.25% died and 79.42% had neurological symptoms, including headache (80.62%), anosmia (32.20%), ageusia (31.96%), myopathy (28.08%), disorientation (14.89%), encephalopathy (12.22%), neuropathy (5.4%), stroke (1.3%), seizures (1.3%), cerebral hemorrhage (1.08%), encephalitis (0.84%), central venous thrombosis (0.36%), and subarachnoid hemorrhage (0.24%). Patients also had comorbidities, such as hypertension (42.30%), diabetes mellitus (38.74%), obesity (61.34%), chronic obstructive pulmonary disease (3.17%), and asthma (2.01%). Factors associated with neurological symptoms were dyspnea, chronic obstructive pulmonary disease, advanced respiratory support, prolonged hospitalization, and worsening fibrinogen levels. Factors associated with death were older age, advanced respiratory support, amine management, chronic obstructive pulmonary disease, intensive care unit management, dyspnea, disorientation, encephalopathy, hypertension, neuropathy, diabetes, male sex, three or more neurological symptoms, and obesity grade 3. In this study we designed a profile to help predict patients at higher risk of developing neurological complications and death following COVID-19 infection.

摘要

我们分析了因新冠肺炎住院的墨西哥患者的神经学表现,并研究了人口统计学、临床和生化变量与包括死亡在内的结局之间的关联。我们使用2020年4月1日至2020年9月30日期间住院患者的电子记录进行了一项回顾性分析研究。分析了1040例患者的记录:31.25%的患者死亡,79.42%的患者有神经症状,包括头痛(80.62%)、嗅觉丧失(32.20%)、味觉丧失(31.96%)、肌病(28.08%)、定向障碍(14.89%)、脑病(12.22%)、神经病变(5.4%)、中风(1.3%)、癫痫发作(1.3%)、脑出血(1.08%)、脑炎(0.84%)、中心静脉血栓形成(0.36%)和蛛网膜下腔出血(0.24%)。患者还患有合并症,如高血压(42.30%)、糖尿病(38.)、肥胖症(61.34%)、慢性阻塞性肺疾病(3.17%)和哮喘(2.01%)。与神经症状相关的因素有呼吸困难、慢性阻塞性肺疾病、高级呼吸支持、住院时间延长和纤维蛋白原水平恶化。与死亡相关的因素有年龄较大、高级呼吸支持、胺类管理、慢性阻塞性肺疾病、重症监护病房管理、呼吸困难、定向障碍、脑病、高血压、神经病变、糖尿病、男性、三种或更多种神经症状以及3级肥胖症。在本研究中,我们设计了一个概况来帮助预测新冠肺炎感染后发生神经并发症和死亡风险较高的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e16/8620259/60de8ed1ba56/healthcare-09-01501-g001.jpg

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