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C 反应蛋白与新冠肺炎患者死亡率的相关性:一项队列研究的二次分析。

Association of C-reactive protein with mortality in Covid-19 patients: a secondary analysis of a cohort study.

机构信息

Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Nanao Street, Dapeng New District, Shenzhen, 518121, Guangdong, China.

Department of Rehabilitation, Futian District, Shenzhen Second People's Hospital/Health Science Centre, The First Affiliated Hospital, School of Medicine, Shenzhen University, No. 3002, Sungang Road, Shenzhen, 518035, Guangdong, China.

出版信息

Sci Rep. 2023 Nov 21;13(1):20361. doi: 10.1038/s41598-023-47680-x.

Abstract

Our study aimed to explore the association between serum C-reactive protein (CRP) and COVID-19 mortality. This is a retrospective cohort study of all patients admitted to 4 hospitals within the Montefiore Health System between March 1 and April 16, 2020, with SARS-CoV-2 infection. All-cause mortality were collected in 7 May 2020. The mortality risk was estimated using Cox proportional hazards models. Of the 3545 patients with a median age of 63.7 years, 918 (25.9%) died within the time of cohort data collection after admission. When the CRP was < 15.6 mg/L, the mortality rate increased with an adjusted HR of 1.57 (95% CI 1.30-1.91, P < 0.0001) for every 10 mg/L increment in the CRP. When the CRP was ≥ 15.6 mg/L, the mortality rate increased with an adjusted HR of 1.11 (95% CI 0.99-1.24, P = 0.0819) for every 10 mg/L increment in the CRP. For patients with COVID-19, the association between the CRP and the mortality risk was curve and had a saturation effect. When the CRP was small, the mortality rate increased significantly with the increase of CRP. When CRP > 15.6 mg/L, with the increase of CRP, the mortality rate increases relatively flat.

摘要

我们的研究旨在探讨血清 C 反应蛋白(CRP)与 COVID-19 死亡率之间的关联。这是一项对 2020 年 3 月 1 日至 4 月 16 日期间在 Montefiore 健康系统内的 4 家医院住院且感染 SARS-CoV-2 的所有患者进行的回顾性队列研究。所有原因的死亡率均在 2020 年 5 月 7 日收集。使用 Cox 比例风险模型估计死亡率风险。在 3545 名中位年龄为 63.7 岁的患者中,有 918 名(25.9%)在入院后队列数据收集期间死亡。当 CRP<15.6mg/L 时,CRP 每增加 10mg/L,调整后的 HR 为 1.57(95%CI 1.30-1.91,P<0.0001),死亡率增加。当 CRP≥15.6mg/L 时,CRP 每增加 10mg/L,调整后的 HR 为 1.11(95%CI 0.99-1.24,P=0.0819),死亡率增加。对于 COVID-19 患者,CRP 与死亡率风险之间的关系呈曲线关系,具有饱和效应。当 CRP 较小时,死亡率随 CRP 的增加而显著增加。当 CRP>15.6mg/L 时,随着 CRP 的增加,死亡率增加相对平坦。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe42/10663442/58e8a4fe47c3/41598_2023_47680_Fig1_HTML.jpg

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