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美国住院 COVID-19 患者和镰状细胞病患者的血红蛋白基因型的人口统计学和结局。

Demographics and outcomes of hemoglobin genotype in hospitalized patients with COVID-19 and sickle cell disease in the United States.

机构信息

Department of Internal Medicine, One Brooklyn Health/Brookdale University Hospital and Medical Center, Brooklyn, New York, USA.

Department of Internal Medicine, North Mississippi Medical Center, Tupelo, Mississippi, USA.

出版信息

Eur J Haematol. 2023 Oct;111(4):611-619. doi: 10.1111/ejh.14054. Epub 2023 Jul 21.

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19) is associated with poor outcomes in sickle cell disease (SCD) patients. However, there is a paucity of data comparing hemoglobin (Hb) genotypes in SCD and infection outcomes.

METHODS

The National Inpatient Sample was used to identify the record of hospitalizations with COVID-19 and SCD in 2020 using the International Classification of Disease, Tenth Revision codes. Study outcomes (invasive mechanical ventilation, extracorporeal membrane oxygenation, shock, vasopressor use, measures of resource utilization, and in-hospital mortality) were compared between hemoglobin SS, SC, and S-beta thalassemia (Sβ).

RESULTS

Of the 102 975 COVID-19 hospitalizations with SCD, 87.26% had HbSS, 7.16% had HbSC, and 5.58% had HbSβ. Younger patients were more likely to have HbSS, while older patients were likely to have HbSC and HbSβ. HbSS was more frequent with Blacks, while HbSβ was more prevalent with Whites and Hispanics. Though measures of resource utilization were higher in HbSS, there was no significant difference in in-hospital outcomes between the three genotypes.

CONCLUSION

There is no difference in COVID-19 outcomes among Hb genotypes in SCD. Further studies are needed to explore the reasons for this observation.

摘要

介绍

2019 年冠状病毒病(COVID-19)与镰状细胞病(SCD)患者的不良结局相关。然而,比较 SCD 患者的血红蛋白(Hb)基因型与感染结局的数据却很少。

方法

使用国际疾病分类第十次修订版代码,利用国家住院患者样本,确定 2020 年 COVID-19 和 SCD 住院记录。比较血红蛋白 SS、SC 和 S-β地中海贫血(Sβ)之间的研究结果(有创机械通气、体外膜氧合、休克、血管加压素使用、资源利用措施和院内死亡率)。

结果

在 102975 例 COVID-19 合并 SCD 的住院患者中,87.26%为 HbSS,7.16%为 HbSC,5.58%为 HbSβ。年轻患者更有可能患有 HbSS,而年长患者更有可能患有 HbSC 和 HbSβ。HbSS 在黑种人中更为常见,而 HbSβ 在白种人和西班牙裔中更为普遍。尽管 HbSS 的资源利用措施较高,但三种基因型之间的住院结局并无显著差异。

结论

SCD 中不同 Hb 基因型的 COVID-19 结局无差异。需要进一步研究以探讨这一观察结果的原因。

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