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特发性肺纤维化合并 COVID-19 患者的特征和结局:一项多中心回顾性研究。

Characteristics and outcomes of COVID-19 patients with IPF: A multi-center retrospective study.

机构信息

Department of Respiratory Disease, Akdeniz University, Antalya, Turkey.

Department of Respiratory Disease, Cukurova University, Adana, Turkey.

出版信息

Respir Med Res. 2022 May;81:100900. doi: 10.1016/j.resmer.2022.100900. Epub 2022 Mar 3.

Abstract

BACKGROUND

There are few data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) infection in patients with idiopathic pulmonary fibrosis (IPF). The objective of this study is to describe the characteristics and outcomes of IPF patients confirmed COVID-19 infection.

METHODS

In this retrospective, multi-center, cohort study, patients from 4 hospital medical records with known IPF and a COVID-19 diagnosis were identified. Demographic and clinical outcome data were abstracted through a review of electronic medical records.

RESULTS

Records for 46 patients with IPF and COVID-19 were abstracted. The mean age was 65±10 years. The most common symptom was dyspnea, followed by fever and cough. Ground-glass opacities (n = 35, 83.3%) and consolidations (n = 11, 26.1%) were the main imaging features of the disease in thorax computed tomography (CT). Twenty-four patients (52.1%) required hospitalization. Among the hospitalized patients, 16 (66.6%) were admitted to the intensive care unit (ICU), and 10 (41.6%) underwent invasive mechanical ventilation. Thirteen patients (28.2%) died of COVID-19 complications. Mortality rate was significantly associated with lower DLCO/VA, long term oxygen therapy and consolidation finding on CT of thorax (p<0.05). On multivariable analysis, neither factor was associated with hospitalization or mortality.

CONCLUSIONS

IPF patients represent a vulnerable population for COVID-19, according to the high rate of hospitalization, ICU requirement, and mortality rate. Measures to minimize the risk of COVID-19 infection remain key to protect IPF patients.

摘要

背景

关于特发性肺纤维化(IPF)患者严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)(COVID-19)感染的数据很少。本研究的目的是描述确诊 COVID-19 感染的 IPF 患者的特征和结局。

方法

在这项回顾性、多中心队列研究中,从 4 家医院的病历中确定了已知患有 IPF 和 COVID-19 的患者。通过审查电子病历,提取人口统计学和临床结局数据。

结果

共提取了 46 例 IPF 和 COVID-19 患者的记录。平均年龄为 65±10 岁。最常见的症状是呼吸困难,其次是发热和咳嗽。肺部计算机断层扫描(CT)的主要影像学特征是磨玻璃影(n=35,83.3%)和实变(n=11,26.1%)。24 例患者(52.1%)需要住院治疗。在住院患者中,16 例(66.6%)入住重症监护病房(ICU),10 例(41.6%)接受有创机械通气。13 例患者(28.2%)死于 COVID-19 并发症。死亡率与较低的 DLCO/VA、长期氧疗和胸部 CT 实变发现显著相关(p<0.05)。多变量分析显示,没有一个因素与住院或死亡率相关。

结论

根据住院、入住 ICU 和死亡率高的情况,IPF 患者是 COVID-19 的高危人群。最大限度地降低 COVID-19 感染风险的措施仍然是保护 IPF 患者的关键。

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