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新型冠状病毒肺炎住院患者胃肠道症状和呼吸困难的评估:对临床病程和死亡率的影响

Assessment of Gastrointestinal Symptoms and Dyspnea in Patients Hospitalized due to COVID-19: Contribution to Clinical Course and Mortality.

作者信息

Kaliszewski Krzysztof, Diakowska Dorota, Nowak Łukasz, Tokarczyk Urszula, Sroczyński Maciej, Sępek Monika, Dudek Agata, Sutkowska-Stępień Karolina, Kiliś-Pstrusińska Katarzyna, Matera-Witkiewicz Agnieszka, Pomorski Michał, Protasiewicz Marcin, Sokołowski Janusz, Adamik Barbara, Kujawa Krzysztof, Doroszko Adrian, Madziarska Katarzyna, Jankowska Ewa Anita

机构信息

Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland.

Department of Basic Science, Faculty of Health Science, Wroclaw Medical University, Bartel Street 5, 51-618 Wroclaw, Poland.

出版信息

J Clin Med. 2022 Mar 25;11(7):1821. doi: 10.3390/jcm11071821.

Abstract

Gastrointestinal manifestations may accompany the respiratory symptoms of COVID-19. Abdominal pain (AP) without nausea and vomiting is one of the most common. To date, its role and prognostic value in patients with COVID-19 is still debated. Therefore, we performed a retrospective analysis of 2184 individuals admitted to hospital due to COVID-19. We divided the patients into four groups according to presented symptoms: dyspnea, n = 871 (39.9%); AP, n = 97 (4.4%); AP with dyspnea together, n = 50 (2.3%); and patients without dyspnea and AP, n = 1166 (53.4%). The patients with AP showed tendency to be younger than these with dyspnea, but without AP (63.0 [38.0−70.0] vs. 65.0 [52.0−74.0] years, p = 0.061), and they were more often females as compared to patients with dyspnea (57.7% vs. 44.6%, p = 0.013, for females). Patients with AP as a separate sign of COVID-19 significantly less often developed pneumonia as compared to individuals with dyspnea or with dyspnea and AP together (p < 0.0001). Patients with AP or AP with dyspnea were significantly less frequently intubated or transferred to the intensive care unit (p = 0.003 and p = 0.031, respectively). Individuals with AP alone or with dyspnea had significantly lower rate of mortality as compared to patients with dyspnea (p = 0.003). AP as a separate symptom and also as a coexisting sign with dyspnea does not predispose the patients with COVID-19 to the worse clinical course and higher mortality.

摘要

胃肠道表现可能伴随新型冠状病毒肺炎(COVID-19)的呼吸道症状。无恶心和呕吐的腹痛(AP)是最常见的症状之一。迄今为止,其在COVID-19患者中的作用和预后价值仍存在争议。因此,我们对2184例因COVID-19入院的患者进行了回顾性分析。我们根据出现的症状将患者分为四组:呼吸困难组,n = 871例(39.9%);AP组,n = 97例(4.4%);AP合并呼吸困难组,n = 50例(2.3%);无呼吸困难和AP组,n = 1166例(53.4%)。与无AP的呼吸困难患者相比,AP患者倾向于更年轻(63.0 [38.0−70.0]岁 vs. 65.0 [52.0−74.0]岁,p = 0.061),且与呼吸困难患者相比,女性比例更高(女性分别为57.7%和44.6%,p = 0.013)。与呼吸困难患者或呼吸困难合并AP患者相比,以AP作为COVID-19单独症状的患者发生肺炎的频率显著更低(p < 0.0001)。AP患者或AP合并呼吸困难患者插管或转入重症监护病房的频率显著更低(分别为p = 0.003和p = 0.031)。与呼吸困难患者相比,单独有AP或合并呼吸困难的患者死亡率显著更低(p = 0.003)。AP作为单独症状以及与呼吸困难并存的症状,并不会使COVID-19患者的临床病程更差、死亡率更高。

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