Pranshu Kumar, Shahul Aneesa, Singh Surjit, Kuwal Ashok, Sonigra Maldev, Dutt Naveen
Department of Pulmonary Medicine, Pacific Institute of Medical Sciences, Udaipur.
Department of Pulmonary Medicine, AIIMS, Jodhpur.
Can J Respir Ther. 2022 Jul 26;58:98-102. doi: 10.29390/cjrt-2022-019. eCollection 2022.
The severity of disease and mortality due to coronavirus disease (COVID-19) was found to be high among patients with concurrent medical illnesses. Serum biomarkers can be used to predict the course of COVID-19 pneumonia. Data from India are very scarce about predictors of mortality among COVID-19 patients.
In the present retrospective study of 65 RT-PCR confirmed COVID-19 patients, we retrieved data regarding clinical symptoms, laboratory parameters, and radiological grading of severity. Further, we also collected data about their hospital course, duration of stay, treatment, and outcome. Data analysis was done to compare the patient characteristics between survivor and non-survivor groups and to assess the predictors of mortality.
The mean age of the study population was 56.23 years (SD, 12.91) and most of them were males (63%); 81.5% of patients survived and were discharged, whereas 18.5% of patients succumbed to the disease. Univariate analysis across both groups showed that older age, diabetes mellitus, higher computed tomogram (CT) severity score, and raised levels of laboratory parameters viz, D-dimer, CPK-MB (creatine kinase), and lactate dehydrogenase (LDH) were associated with increased mortality among hospitalized patients. On multivariate analysis, elevated levels of serum D-dimer (odds ratio, 95% CI: 10.98, 1.13-106.62, = 0.04) and LDH (odds ratio, 95% CI: 19.15, 3.28-111.87, = 0.001) were independently associated with mortality.
Older patients, diabetics, and patients with high CT severity scores at admission are at increased risk of death from COVID-19. Serum biomarkers such as D-dimer and LDH help in predicting mortality in COVID-19 patients.
研究发现，患有合并症的冠状病毒病（COVID-19）患者的疾病严重程度和死亡率较高。血清生物标志物可用于预测COVID-19肺炎的病程。关于COVID-19患者死亡率预测因素的印度数据非常稀少。
在这项对65例经逆转录聚合酶链反应（RT-PCR）确诊的COVID-19患者的回顾性研究中，我们获取了有关临床症状、实验室参数和严重程度的放射学分级的数据。此外，我们还收集了他们的住院病程、住院时间、治疗情况和结局的数据。进行数据分析以比较存活组和非存活组之间的患者特征，并评估死亡率的预测因素。
研究人群的平均年龄为56.23岁（标准差，12.91），其中大多数为男性（63%）；81.5%的患者存活并出院，而18.5%的患者死于该疾病。两组的单因素分析表明，年龄较大、患有糖尿病、计算机断层扫描（CT）严重程度评分较高以及实验室参数即D-二聚体、肌酸磷酸激酶同工酶（CPK-MB）和乳酸脱氢酶（LDH）水平升高与住院患者死亡率增加相关。多因素分析显示，血清D-二聚体水平升高（比值比，95%置信区间：10.98，1.13 - 106.62，P = 0.04）和LDH水平升高（比值比，95%置信区间：19.15，3.28 - 1'11.87，P = 0.001）与死亡率独立相关。
老年患者、糖尿病患者以及入院时CT严重程度评分高的患者死于COVID-19的风险增加。血清生物标志物如D-二聚体和LDH有助于预测COVID-19患者的死亡率。
