University of Illinois at Chicago, College of Pharmacy, Chicago, IL 60612, USA.
University of Illinois at Chicago, College of Pharmacy, Chicago, IL 60612, USA.
Heart Lung. 2023 Sep-Oct;61:153-157. doi: 10.1016/j.hrtlng.2023.05.005. Epub 2023 May 17.
Infection with viral pneumonia (PNA) is known to offset the coagulation cascade. Recent studies assessing novel SARS-CoV-2 infection observed a high frequency of systemic thrombotic events resulting in ambiguity if severity of infection or specific viral strain drive thrombosis and worsen clinical outcomes. Furthermore, limited data exists addressing SARS-CoV-2 in underrepresented patient populations.
Assess clinical outcomes events and death in patients diagnosed with SARS-CoV-2 pneumonia compared to patients with other types of viral pneumonia.
Retrospective cohort study evaluated electronic medical records in adult patients admitted to University of Illinois Hospital and Health Sciences System (UIHHSS) with primary diagnosis of SARS-CoV-2 PNA or other viral (H1N1 or H3N2) PNA between 10/01/2017 and 09/01/2020. Primary composite outcome was the following event incidence rates: death, ICU admission, infection, thrombotic complications, mechanical ventilation, renal replacement therapy, and major bleeding.
Of 257 patient records, 199 and 58 patients had SARS-CoV-2 PNA and other viral PNA, respectively. There was no difference in primary composite outcome. Thrombotic events (n = 6, 3%) occurred solely in SARS-CoV-2 PNA patients in the ICU. A significantly higher incidence of renal replacement therapy (8.5% vs 0%, p=0.016) and mortality (15.6% vs 3.4%, p=0.048) occurred in the SARS-CoV-2 PNA group. Multivariable logistic regression analysis revealed age, presence of SARS-CoV-2, and ICU admission, aOR 1.07, 11.37, and 41.95 respectively, was significantly associated with mortality risk during hospitalization; race and ethnicity were not.
Low overall incidence of thrombotic events occurred only in the SARS-CoV-2 PNA group. SARS-CoV-2 PNA may lead to higher incidence of clinical events than those observed in H3N2/H1N1 viral pneumonia, and that race/ethnicity does not drive mortality outcomes.
已知病毒性肺炎（PNA）感染会干扰凝血级联反应。最近评估新型 SARS-CoV-2 感染的研究观察到全身性血栓形成事件的高发率，导致感染的严重程度或特定病毒株是否引发血栓形成以及使临床结果恶化存在不确定性。此外，关于代表性不足的患者人群中的 SARS-CoV-2，目前数据有限。
评估与其他类型病毒性肺炎患者相比，诊断为 SARS-CoV-2 肺炎的患者的临床结局事件和死亡情况。
回顾性队列研究评估了 2017 年 10 月 1 日至 2020 年 9 月 1 日期间在伊利诺伊大学医院和健康科学系统（UIHHSS）住院的成人患者的电子病历，这些患者的主要诊断为 SARS-CoV-2 PNA 或其他病毒性（H1N1 或 H3N2）PNA。主要复合结局是以下事件发生率：死亡、入住 ICU、感染、血栓并发症、机械通气、肾脏替代治疗和大出血。
在 257 份患者记录中，199 份和 58 份记录分别为 SARS-CoV-2 PNA 和其他病毒性 PNA。主要复合结局没有差异。血栓形成事件（n=6，3%）仅发生在 SARS-CoV-2 PNA 患者的 ICU 中。SARS-CoV-2 PNA 组的肾脏替代治疗（8.5%比 0%，p=0.016）和死亡率（15.6%比 3.4%，p=0.048）的发生率显著更高。多变量逻辑回归分析显示，年龄、存在 SARS-CoV-2 和入住 ICU 与住院期间的死亡率风险相关，优势比（aOR）分别为 1.07、11.37 和 41.95；种族和民族没有关系。
仅在 SARS-CoV-2 PNA 组中发生总体发生率较低的血栓形成事件。SARS-CoV-2 PNA 可能导致比 H3N2/H1N1 病毒性肺炎观察到的更高的临床事件发生率，并且种族/民族不会导致死亡率结果。
