Motoc Nicoleta Ștefania, Făgărășan Iulia, Urda-Cîmpean Andrada Elena, Todea Doina Adina
Department of Medical Sciences-Pulmonology, Faculty of Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, 8 Victor Babeș Street, 400012 Cluj-Napoca, Romania.
Department of Medical Informatics and Biostatistics, Faculty of Medicine, "Iuliu Haţieganu" University of Medicine and Pharmacy, Louis Pasteur Str. No. 6, 400349 Cluj-Napoca, Romania.
Diagnostics (Basel). 2023 Aug 4;13(15):2597. doi: 10.3390/diagnostics13152597.
Some studies have reported that chronic respiratory illnesses in patients with COVID-19 result in an increase in hospitalization and death rates, while other studies reported to the contrary. The present research aims to determine if a predictive model (developed by combing different clinical, imaging, or blood markers) could be established for patients with both chronic obstructive pulmonary disease (COPD) and COVID-19, in order to be able to foresee the outcomes of these patients. A prospective observational cohort of 165 patients with both diseases was analyzed in terms of clinical characteristics, blood tests, and chest computed tomography results. The beta-coefficients from the logistic regression were used to create a score based on the significant identified markers for poor outcomes (transfers to an intensive care unit (ICU) for mechanical ventilation, or death). The severity of COVID-19, renal failure, diabetes, smoking status (current or previous), the requirement for oxygen therapy upon admission, high lactate dehydrogenase (LDH) and C-reactive protein level (CRP readings), and low eosinophil and lymphocyte counts were all identified as being indicators of a poor prognosis. Higher mortality was linked to the occurrence of renal failure, the number of affected lobes, the need for oxygen therapy upon hospital admission, high LDH, and low lymphocyte levels. Patients had an 86.4% chance of dying if their mortality scores were -2.80 or lower, based on the predictive model. The factors that were linked to a poor prognosis in patients who had both COPD and COVID-19 were the same as those that were linked to a poor prognosis in patients who had only COVID-19.
一些研究报告称，新冠肺炎患者的慢性呼吸道疾病会导致住院率和死亡率上升，而其他研究则得出了相反的结论。本研究旨在确定是否可以为慢性阻塞性肺疾病（COPD）合并新冠肺炎的患者建立一个预测模型（通过结合不同的临床、影像学或血液标志物开发），以便能够预见这些患者的预后。对165例患有这两种疾病的患者进行了前瞻性观察队列研究，分析了其临床特征、血液检查和胸部计算机断层扫描结果。逻辑回归的β系数用于根据确定的不良预后显著标志物（转入重症监护病房（ICU）进行机械通气或死亡）创建一个评分。新冠肺炎的严重程度、肾衰竭、糖尿病、吸烟状况（当前或既往）、入院时对氧疗的需求、高乳酸脱氢酶（LDH）和C反应蛋白水平（CRP读数）以及低嗜酸性粒细胞和淋巴细胞计数均被确定为预后不良的指标。较高的死亡率与肾衰竭的发生、受累肺叶数量、入院时对氧疗的需求、高LDH和低淋巴细胞水平有关。根据预测模型，如果患者的死亡率评分在-2.80或更低，则其死亡几率为86.4%。COPD合并新冠肺炎患者预后不良的相关因素与仅患有新冠肺炎患者预后不良的相关因素相同。
