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感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)不同变异株的社区获得性肺炎(CAP)住院患者及非新型冠状病毒肺炎(COVID-19)CAP患者的特征、结局及影响死亡率的因素

Characteristics, Outcomes, and Factors Affecting Mortality in Hospitalized Patients with CAP Due to Different Variants of SARS-CoV-2 and Non-COVID-19 CAP.

作者信息

Tongsengkee Nonthanat, Surasombatpattana Smonrapat, Tanomkiat Wiwatana, Siripaitoon Pisud, Kositpantawong Narongdet, Kanchanasuwan Siripen, Navasakulpong Asma, Pinpathomrat Nawamin, Dechaphunkul Arunee, Phongphithakchai Atthaphong, Hortiwakul Thanaporn, Charoenmak Boonsri, Chusri Sarunyou

机构信息

Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.

Department of Pathology, Division of Virology and Serology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.

出版信息

J Clin Med. 2023 Feb 9;12(4):1388. doi: 10.3390/jcm12041388.

Abstract

The study was conducted from October 2020 to March 2022 in a province in southern Thailand. The inpatients with community-acquired pneumonia (CAP) and more than 18 years old were enrolled. Of the 1511 inpatients with CAP, COVID-19 was the leading cause, accounting for 27%. Among the patients with COVID-19 CAP, mortalities, mechanical ventilators, ICU admissions, ICU stay, and hospital costs were significantly higher than of those with non-COVID-19 CAP. Household and workplace contact with COVID-19, co-morbidities, lymphocytopenia and peripheral infiltration in chest imaging were associated with CAP due to COVID-19. The delta variant yielded the most unfavorable clinical and non-clinical outcomes. While COVID-19 CAP due to B.1.113, Alpha and Omicron variants had relatively similar outcomes. Among those with CAP, COVID-19 infection as well as obesity, a higher Charlson comorbidity index (CCI) and APACHE II score were associated with in-hospital mortality. Among those with COVID-19 CAP, obesity, infection due to the Delta variant, a higher CCI and higher APACHE II score were associated with in-hospital mortality. COVID-19 had a great impact on the epidemiology and outcomes of CAP.

摘要

该研究于2020年10月至2022年3月在泰国南部的一个省份进行。纳入了年龄超过18岁的社区获得性肺炎(CAP)住院患者。在1511例CAP住院患者中,新冠病毒病是主要病因,占27%。在新冠病毒病相关CAP患者中,死亡率、机械通气使用率、入住重症监护病房(ICU)率、在ICU的停留时间和住院费用均显著高于非新冠病毒病相关CAP患者。家庭和工作场所接触新冠病毒病、合并症、淋巴细胞减少以及胸部影像学检查中的外周浸润与新冠病毒病相关的CAP有关。德尔塔变异株导致了最不利的临床和非临床结局。而B.1.113、阿尔法和奥密克戎变异株导致的新冠病毒病相关CAP的结局相对相似。在CAP患者中,新冠病毒病感染以及肥胖、较高的查尔森合并症指数(CCI)和急性生理学与慢性健康状况评分系统II(APACHE II)评分与住院死亡率相关。在新冠病毒病相关CAP患者中,肥胖、德尔塔变异株感染、较高的CCI和较高的APACHE II评分与住院死亡率相关。新冠病毒病对CAP的流行病学和结局产生了重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42dd/9964315/e593d6d00042/jcm-12-01388-g001.jpg

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