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高尿酸血症与 COVID-19 住院患者不良结局的关系。

Hyperuricemia and Adverse Outcomes in Patients Hospitalized for COVID-19 Disease.

机构信息

Department of Internal Medicine, Rheumatology Unit, Shaare Zedek Medical Center

Department of Internal Medicine, Rheumatology Unit, Shaare Zedek Medical Center.

出版信息

Clin Med Res. 2023 Jun;21(2):87-94. doi: 10.3121/cmr.2023.1782.

Abstract

Hyperuricemia is associated with several risk factors for mortality and severe coronavirus disease 2019 (COVID-19) manifestations. The objective of this research was to examine whether hyperuricemia is a risk factor for mortality and other adverse outcomes in patients hospitalized for COVID-19. This is a retrospective review of patients hospitalized for COVID-19 between March 15 and November 30, 2020, with available uric acid (UA) levels. Among 1566 patients who were hospitalized during the study period, 222 patients had an available UA level. The mean age ± standard deviation (SD) was 56.5 ± 19.5 years. The mean ± SD for UA (mg/dL) among the total cohort was 5.65 ± 2.18, and 21.2% of the total study population had hyperuricemia (UA > 7 mg/dL) on admission. The mortality rate was 14.4%, and mortality was associated with higher UA levels on admission (6.9 ± 2.6 mg/dL vs. 5.5 ± 2 mg/dL in patients who survived, < 0.05). Patients who needed intensive oxygen support (high-flow nasal cannula or mechanical ventilation) and those who required longer-than-average hospitalization (> 7 days) had more hyperuricemia (intensive oxygen support: 30% vs. 18%, = 0.07; long hospitalization 29% vs. 16.2%, < 0.05). Our findings show that high UA levels are associated with adverse outcomes in patients hospitalized for COVID-19. We suggest evaluating hyperuricemia as a marker that integrates and reflects both poor prognostic baseline characteristics and acute components such as inflammatory state, hypovolemic state, and renal failure.

摘要

高尿酸血症与多种死亡风险因素和严重 2019 冠状病毒病(COVID-19)表现相关。本研究旨在探讨高尿酸血症是否为 COVID-19 住院患者死亡和其他不良结局的危险因素。这是一项对 2020 年 3 月 15 日至 11 月 30 日期间住院的 COVID-19 患者进行的回顾性研究,研究对象为有尿酸(UA)水平检测结果的患者。在研究期间住院的 1566 例患者中,有 222 例患者的 UA 水平可查。患者的平均年龄±标准差(SD)为 56.5±19.5 岁。总队列的 UA(mg/dL)平均水平±SD 为 5.65±2.18,总研究人群中有 21.2%(21.2%)入院时患有高尿酸血症(UA>7mg/dL)。死亡率为 14.4%,死亡率与入院时 UA 水平升高相关(6.9±2.6mg/dL 与存活患者的 5.5±2mg/dL 相比,<0.05)。需要强化氧支持(高流量鼻导管或机械通气)的患者和需要较长住院时间(>7 天)的患者高尿酸血症的发生率更高(强化氧支持:30%比 18%,=0.07;长住院时间:29%比 16.2%,<0.05)。本研究结果表明,高 UA 水平与 COVID-19 住院患者的不良结局相关。我们建议将高尿酸血症评估为一种标志物,该标志物综合反映了不良预后的基线特征和急性炎症状态、低血容量状态和肾衰竭等急性成分。

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