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比较 ICU 中四种呼吸道病毒的死亡率和结局:一项多中心回顾性研究。

Comparison of mortality and outcomes of four respiratory viruses in the intensive care unit: a multicenter retrospective study.

机构信息

Service de Médecine Intensive Réanimation, Hôpital Lyon SUD, 415 chemin du grand Revoyet, 69495, Pierre-Bénite, France.

Service de Biostatistique - Bio-informatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France.

出版信息

Sci Rep. 2024 Mar 20;14(1):6690. doi: 10.1038/s41598-024-55378-x.

Abstract

This retrospective study aimed to compare the mortality and burden of respiratory syncytial virus (RSV group), SARS-CoV-2 (COVID-19 group), non-H1N1 (Seasonal influenza group) and H1N1 influenza (H1N1 group) in adult patients admitted to intensive care unit (ICU) with respiratory failure. A total of 807 patients were included. Mortality was compared between the four following groups: RSV, COVID-19, seasonal influenza, and H1N1 groups. Patients in the RSV group had significantly more comorbidities than the other patients. At admission, patients in the COVID-19 group were significantly less severe than the others according to the simplified acute physiology score-2 (SAPS-II) and sepsis-related organ failure assessment (SOFA) scores. Using competing risk regression, COVID-19 (sHR = 1.61; 95% CI 1.10; 2.36) and H1N1 (sHR = 1.87; 95% CI 1.20; 2.93) were associated with a statistically significant higher mortality while seasonal influenza was not (sHR = 0.93; 95% CI 0.65; 1.31), when compared to RSV. Despite occurring in more severe patients, RSV and seasonal influenza group appear to be associated with a more favorable outcome than COVID-19 and H1N1 groups.

摘要

本回顾性研究旨在比较因呼吸衰竭而入住重症监护病房(ICU)的成年患者中,呼吸道合胞病毒(RSV 组)、严重急性呼吸综合征冠状病毒 2(SARS-CoV-2,即 COVID-19)、非 H1N1(季节性流感组)和 H1N1 流感(H1N1 组)患者的死亡率和负担。共纳入 807 例患者。比较了以下四个组的死亡率:RSV、COVID-19、季节性流感和 H1N1 组。RSV 组患者的合并症明显多于其他患者。根据简化急性生理学评分-2(SAPS-II)和脓毒症相关器官衰竭评估(SOFA)评分,COVID-19 组患者入院时的严重程度明显低于其他患者。使用竞争风险回归,COVID-19(sHR=1.61;95%CI 1.10;2.36)和 H1N1(sHR=1.87;95%CI 1.20;2.93)与死亡率显著升高相关,而季节性流感则没有(sHR=0.93;95%CI 0.65;1.31),与 RSV 相比。尽管 RSV 和季节性流感组发生在更严重的患者中,但它们的预后似乎比 COVID-19 和 H1N1 组更有利。

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