Amer Fatma Abdelaziz, Saeed Maysaa Abdallah, Wagih Shaltout Shaker, Nofal Hanaa Abu Elazayem, Nafae Ramadan Mahmoud, Arslan Kadem, Tanoglu Alpaslan, Nechifor Mihai, Luca Catalina, Al-Kadhim Zaid Hashim Ali, Mosallem Ahmed, Hammad Noha Mohammed
Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Viral Infection Working Group of International Society of Antimicrobial Chemotherapy VIWG/ISAC.
J Infect Dev Ctries. 2022 Nov 29;16(11):1715-1725. doi: 10.3855/jidc.16696.
To date, the world has experienced four waves of the Coronavirus disease- 19 (COVID-19) pandemic. Patients infected during the era of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant were the subject of this study. The objectives were to describe their clinical manifestations, explain their laboratory and radiological findings, conclude factors contributing to clinical outcomes, and evaluate treatment protocols.
Relevant data were collected retrospectively from records of patients admitted to six referral centers in four countries. Data included sociodemographic patterns, symptoms, associated comorbidities, physical examination, laboratory and radiologic findings, treatment received, and patient outcomes.
Data analysis identified symptomatology and variables related to acquisition and infection outcome. The most prevalent symptoms were cough (81.5%), body aches (74.1%), and fever (71.6%). Independent risk factors for mortality were age, vomiting, epigastric pain, diabetes, obesity, oxygen saturation less than 90%, leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated creatinine, high glucose level, lung ground glass opacities with consolidation, affection of four lobes and bilateralism. Neither d-dimer nor lactate dehydrogenase nor ferritin foretells death possibility. The efficacy of the medications used was convenient.
Assessing the clinical features of different COVID-19 waves, identifying predictors of outcomes, and concluding the efficacy of treatment protocols provide insight into patients' responses and viral behaviors, which help in the proper diagnosis and treatment of subsequent surges.
迄今为止,全球已经历了四波新型冠状病毒肺炎(COVID-19)大流行。本研究的对象是在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)德尔塔变异株流行期间感染的患者。目的是描述他们的临床表现,解释其实验室和影像学检查结果,总结影响临床结局的因素,并评估治疗方案。
回顾性收集了来自四个国家六个转诊中心收治患者的记录中的相关数据。数据包括社会人口学模式、症状、合并症、体格检查、实验室和影像学检查结果、接受的治疗以及患者结局。
数据分析确定了与感染及感染结局相关的症状和变量。最常见的症状是咳嗽(81.5%)、全身疼痛(74.1%)和发热(71.6%)。死亡的独立危险因素包括年龄、呕吐、上腹部疼痛、糖尿病、肥胖、氧饱和度低于90%、白细胞增多、中性粒细胞增多、淋巴细胞减少、血小板减少、肌酐升高、血糖水平升高、肺部磨玻璃影伴实变、累及四个肺叶及双侧受累。D-二聚体、乳酸脱氢酶和铁蛋白均不能预示死亡可能性。所用药物的疗效良好。
评估不同COVID-19波次的临床特征、确定结局的预测因素并总结治疗方案的疗效,有助于深入了解患者的反应和病毒行为,从而有助于对后续疫情高峰进行正确诊断和治疗。