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印度北部一家三级护理医院过去两波新冠疫情期间新冠病毒病死亡患者的临床流行病学概况:一项回顾性描述性研究

Clinico-epidemiological profile of non-survivors of COVID-19 during the last two waves in a tertiary care hospital of North India: A retrospective descriptive study.

作者信息

Husaini Syed H M, Waseem Shah M A, Siddiqui Zia, Ali Wasif M, Nasreen Farah, Athar Manazir, Ahmad Manzoor, Khan Haris M

机构信息

Department of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Department of Physiology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

出版信息

J Family Med Prim Care. 2023 Oct;12(10):2385-2391. doi: 10.4103/jfmpc.jfmpc_307_23. Epub 2023 Oct 11.

DOI:10.4103/jfmpc.jfmpc_307_23
PMID:38074239
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10706549/
Abstract

BACKGROUND

SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection.

METHOD

Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a value<0.05 was taken as significant.

RESULTS

60.94% and 39.06 % were males and females, and 26.57% & 73.43 % of patients had moderate and severe disease, respectively. Fever, cough, and dyspnea were the most common presenting symptoms. 78.12% and 21.88% had pre-existing (diabetes and hypertension were most common) and no co-morbidities, respectively. 65.62 & 17.19 % of patients had bilateral and unilateral ground glass opacities, respectively. Thrombocytopenia, lymphopenia, neutrophilia, elevated monocytes, and neutrophil-lymphocyte ratio (NLR) of 7.52 were hematological findings. D dimer was elevated. ABG showed low PaO2 and SPO2 %. ALT and AST were elevated. Tachycardia was also present. Compared to the first wave, no significant association of gender with severity was found. However, the percentage of male patients was higher. The association of the duration of stay and co-morbidity with disease severity was significant in both the first and subsequent waves of COVID-19.

CONCLUSION

Co-morbidity, disease severity, and radiological lung opacities play a role in the outcome of COVID-19. The associated findings are hematological, renal, liver, cardiovascular, and arterial blood gas derangements.

摘要

背景

导致新冠肺炎的严重急性呼吸综合征冠状病毒(SARS-CoV)可导致死亡,对后来死亡患者入院时的临床流行病学特征进行分析,有助于深入了解感染所致的病理生理后果。

方法

对2021年4月至6月以及2022年1月至2月期间64例经逆转录聚合酶链反应(RT-PCR)确诊的新冠肺炎死亡病例进行回顾性观察研究。对数据进行分析,P值<0.05被视为具有统计学意义。

结果

男性和女性患者分别占60.94%和39.06%,26.57%和73.43%的患者病情为中度和重度。发热、咳嗽和呼吸困难是最常见的首发症状。分别有78.12%和21.88%的患者有基础疾病(最常见的是糖尿病和高血压)和无基础疾病。分别有65.62%和17.19%的患者出现双侧和单侧磨玻璃影。血小板减少、淋巴细胞减少、中性粒细胞增多、单核细胞升高以及中性粒细胞与淋巴细胞比值(NLR)为7.52是血液学检查结果。D-二聚体升高。动脉血气分析显示动脉血氧分压(PaO2)和血氧饱和度(SPO2%)降低。谷丙转氨酶(ALT)和谷草转氨酶(AST)升高。还存在心动过速。与第一波疫情相比,未发现性别与病情严重程度之间存在显著关联。然而,男性患者的比例更高。在新冠肺炎的第一波及后续疫情中,住院时间和基础疾病与疾病严重程度之间的关联均具有统计学意义。

结论

基础疾病、疾病严重程度和肺部影像学磨玻璃影在新冠肺炎的预后中起作用。相关表现包括血液学、肾脏、肝脏、心血管和动脉血气紊乱。