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德尔塔-奥密克戎毒株流行期间新冠病毒肺炎患者的临床和生化特征及不良结局风险评估

Clinical and Biochemical Characteristics of COVID-19 Patients During the Delta-Omicron Wave with Risk Assessment of Adverse Outcomes.

作者信息

Iqbal Sahar, Khan Saeed, Qureshi Muhammad Asif, Sayeed Muneeba Ahsan, Khan Bilal Ahmed, Zaheer Sidra, Faruqui Hafsa, Rajput Abdul Wahid

机构信息

Department of Pathology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Department of Infectious Diseases, Sindh Infectious Diseases Hospital and Research Centre, Karachi, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2023 Mar;33(3):297-302. doi: 10.29271/jcpsp.2023.03.297.

Abstract

OBJECTIVE

To compare clinical and biochemical characteristics of hospitalised COVID-19 patients and risk assessment of disease outcomes Study Design: Descriptive study. Place and Duration of the Study: Department of Pathology, Dow International Medical College and Sindh Infectious Diseases Hospital and Research Centre, from January to March 2022 Methodology: SARS CoV-2 PCR-positive hospitalised patients were enrolled. Delta or omicron variants infected patients were followed till the last recorded event of hospitalisation. After a detailed history, clinical and biochemical profiles were recorded during the hospitalisation. Length of hospitalisation, ICU admission and in-hospital mortality were taken as outcomes and odd ratios were calculated.

RESULTS

During the study period, omicron was the predominant SARS CoV-2 variant. Omicron-infected patient were older (67 vs. 62 years) and had a significantly shorter duration between appearance of symptoms and hospitalisation (5 vs. 8 days), when compared with the delta patients. Median values of LDH, ferritin and TLC were significantly higher in delta patients (p<0.05). Delta infected patients have a 3.9 times more risk of prolonged hospital stay. In patients with increased TLC, the risk of prolonged hospitalisation and ICU admission was found 16% and 23%, respectively. However, the aOR for ICU admission and in- Hospital mortality were not found significant for the delta and omicron-infected patients.

CONCLUSION

The clinical course and biochemical profiles are diverse in delta and omicron patients. Hospitalised patients with omicron infection exhibit shorter stays. High values of TLC are found associated with an increased risk of longer hospital stay and ICU admissions.

KEY WORDS

COVID-19, Delta variant, Omicron variant, Hospitalised patients, Outcomes, In-hospital mortality, Biochemical markers, Clinical severity.

摘要

目的

比较住院的新冠病毒疾病(COVID-19)患者的临床和生化特征以及疾病结局的风险评估。研究设计:描述性研究。研究地点和时间:陶氏国际医学院病理科以及信德传染病医院和研究中心,2022年1月至3月。方法:纳入SARS-CoV-2 PCR检测呈阳性的住院患者。对感染德尔塔或奥密克戎变异株的患者进行随访,直至最后一次记录的住院事件。详细询问病史后,记录住院期间的临床和生化指标。将住院时间、入住重症监护病房(ICU)情况和院内死亡率作为结局指标,并计算比值比。

结果

在研究期间,奥密克戎是主要的SARS-CoV-2变异株。与感染德尔塔变异株的患者相比,感染奥密克戎变异株的患者年龄更大(67岁对62岁),症状出现至住院的时间明显更短(5天对8天)。德尔塔变异株感染患者的乳酸脱氢酶(LDH)、铁蛋白和白细胞总数(TLC)的中位数显著更高(p<0.05)。感染德尔塔变异株的患者住院时间延长的风险高3.9倍。在TLC升高的患者中,住院时间延长和入住ICU的风险分别为16%和23%。然而,对于感染德尔塔和奥密克戎变异株的患者,入住ICU和院内死亡的调整后比值比未发现有显著差异。

结论

德尔塔和奥密克戎变异株感染患者的临床病程和生化指标各不相同。感染奥密克戎变异株的住院患者住院时间较短。TLC值高与住院时间延长和入住ICU的风险增加有关。

关键词

COVID-19;德尔塔变异株;奥密克戎变异株;住院患者;结局;院内死亡率;生化标志物;临床严重程度

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