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沙特阿拉伯住院COVID-19患者危重症的临床特征、结局及预后因素:一项回顾性队列研究

Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study.

作者信息

El-Kady Asmaa M, Aldakheel Fahad M, Allemailem Khaled S, Almatroudi Ahmad, Dbas Alharbi Reem, Al Hamed Hamad, Alsulami Muslimah, Alshehri Wafa A, El-Ashram Saeed, Kreys Eugene, Mohamed Khalil, Al-Megrin Wafa Abdullah I, Elshabrawy Hatem A

机构信息

Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.

Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia.

出版信息

Int J Gen Med. 2022 Aug 31;15:6945-6963. doi: 10.2147/IJGM.S374090. eCollection 2022.

Abstract

BACKGROUND

A good understanding of the possible risk factors for coronavirus disease 19 (COVID-19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcome. In the present study, we aimed to correlate clinical and laboratory characteristics of hospitalized COVID-19 patients to disease outcome in Saudi Arabia.

MATERIALS AND METHODS

The present study included 199 COVID-19 patients admitted to King Fahd Specialist Hospital, Buraydah, Qassim, Saudi Arabia, from April to December 2020. Patients were followed-up until discharge either for recovery or death. Demographic data, clinical data and laboratory results were retrieved from electronic patient records.

RESULTS

Critical COVID-19 cases showed higher mean of age and higher prevalence of co-morbid conditions. Fifty-five patients died during the observation period. Risk factors for in hospital death for COVID 19 patients were leukocytosis (OR 1.89, 95% CI 1.008-3.548, = 0.081), lymphocytopenia (OR 2.152, 95% CI 1.079-4.295, = 0.020), neutrophilia (OR 1.839, 95% CI 0.951-3.55, = 0.047), thrombocytopenia (OR 2.152, 95% CI 0.852-5.430, = 0.085), liver injury (OR 2.689, 95% CI 1.373-4.944, = 0.003), acute kidney injury (OR 1.248, 95% CI 0.631-2.467 = 0.319), pancreatic injury (OR 1.973, 95% CI 0.939-4.144, = 0.056) and high D dimer (OR 2.635, 95% CI 0.747-9.287, = 0.091).

CONCLUSION

Clinical and laboratory data of COVID-19 patients may help understanding the pathogenesis of the disease and subsequently improve of the outcome of patients by determination of the associated risk factors and recognition of high risk group who are more liable for complications and in hospital death. The present study put an eye on some parameters (laboratory and clinical) that should be alarming signs that the patient is at high risk bad prognosis.

摘要

背景

深入了解新型冠状病毒肺炎(COVID-19)严重程度的潜在风险因素,有助于临床医生识别需要优先治疗的患者,以预防疾病进展和不良后果。在本研究中,我们旨在关联沙特阿拉伯住院COVID-19患者的临床和实验室特征与疾病转归。

材料与方法

本研究纳入了2020年4月至12月期间入住沙特阿拉伯卡西姆布赖代国王法赫德专科医院的199例COVID-19患者。对患者进行随访直至出院,记录康复或死亡情况。从电子病历中获取人口统计学数据、临床数据和实验室检查结果。

结果

重症COVID-19病例的平均年龄较高,合并症患病率也较高。55例患者在观察期内死亡。COVID-19患者院内死亡的风险因素包括白细胞增多(比值比[OR]1.89,95%置信区间[CI]1.008 - 3.548,P = 0.081)、淋巴细胞减少(OR 2.152,95% CI 1.079 - 4.295,P = 0.020)、中性粒细胞增多(OR 1.839,95% CI 0.951 - 3.55,P = 0.047)、血小板减少(OR 2.152,95% CI 0.852 - 5.430,P = 0.085)、肝损伤(OR 2.689,95% CI 1.373 - 4.944,P = 0.003)、急性肾损伤(OR 1.248,95% CI 0.631 - 2.467,P = 0.319)、胰腺损伤(OR 1.973,95% CI 0.939 - 4.144,P = 0.056)和高D-二聚体(OR 2.635,95% CI 0.747 - 9.287,P = 0.091)。

结论

COVID-19患者的临床和实验室数据有助于理解疾病的发病机制,进而通过确定相关风险因素和识别更容易出现并发症及院内死亡的高危人群来改善患者的转归。本研究关注了一些(实验室和临床)参数,这些参数应作为患者预后不良的警示信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c335/9441173/b27e2cb253b5/IJGM-15-6945-g0001.jpg

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