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[C反应蛋白对因COVID-19住院的成年人入院时及机械通气需求的预测价值]

[Predictive value of C-reactive protein on hospital admission and mechanical ventilation requirement in adults hospitalized for COVID-19].

作者信息

Guidetto Betiana Alejandra, Fonseca Sebastian, Abrate Alejandro Martin, Politi Maria Teresa

机构信息

Sanatorio Anchorena San Martin.

Sanatorio trinidad palermo.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2024 Mar 27;81(1):67-82. doi: 10.31053/1853.0605.v81.n1.41799.

Abstract

INTRODUCTION

During the COVID-19 pandemic, patients with worse evolution presented clinical deterioration 7-10 days after the onset of symptoms, which suggests that the inflammatory response could participate in the pathophysiology of the disease. The objective of this study was to evaluate the association between plasma C-reactive protein (PCr) on hospital admission and mechanical ventilation requirement during hospitalization in adults with COVID-19.

METHODS

Retrospective, observational cohort at a private center in the province of Buenos Aires. Hospitalized adults diagnosed with COVID-19 by nasal swab using real time transcription polymerase chain reaction or antigen were included. The primary outcome was the association between high plasma PCr values on hospital admission (≥8 mg/L) and mechanical ventilation requirement during hospitalization.

RESULTS

Of the 1,242 patients enrolled, 19.4% required mechanical ventilation and 11.7% died during the hospitalization. The PCr of the patients who required mechanical ventilation was higher than that of those who did not require mechanical ventilation (9.45 [5.20-18.70] mg/L vs 4.95 [1.80-10.70] mg/L; p < 0.01). PCr analyzed as a continuous variable (OR = 1.39; 95%CI 1.21-1.60; p < 0.001) and as a categorical variable (≥8 mg/L) (OR = 2.66; 95%CI 2.19 -3.78, p < 0.001) presented a significant association with the requirement of mechanical ventilation during hospitalization. Additionally, a significant association was found between PCr and in-hospital mortality.

CONCLUSION

Plasma PCr on hospital admission could predict clinical evolution in adult patients hospitalized for COVID-19.

摘要

引言

在新冠疫情期间,病情进展较差的患者在症状出现后7至10天出现临床恶化,这表明炎症反应可能参与了该疾病的病理生理过程。本研究的目的是评估新冠成年患者入院时血浆C反应蛋白(PCr)与住院期间机械通气需求之间的关联。

方法

在布宜诺斯艾利斯省的一家私立中心进行回顾性观察队列研究。纳入通过实时转录聚合酶链反应或抗原鼻拭子诊断为新冠的住院成年患者。主要结局是入院时高血浆PCr值(≥8mg/L)与住院期间机械通气需求之间的关联。

结果

在纳入的1242例患者中,19.4%需要机械通气,11.7%在住院期间死亡。需要机械通气的患者的PCr高于不需要机械通气的患者(9.45[5.20-18.70]mg/L对4.95[1.80-10.70]mg/L;p<0.01)。将PCr作为连续变量分析(OR=1.39;95%CI 1.21-1.60;p<0.001)以及作为分类变量(≥8mg/L)分析(OR=2.66;95%CI 2.19-3.78,p<0.001)时,均显示与住院期间机械通气需求存在显著关联。此外,还发现PCr与院内死亡率之间存在显著关联。

结论

入院时的血浆PCr可以预测新冠住院成年患者的临床进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/501e/11110669/e8beb114ceb8/1853-0605-81-1-67-g001.jpg

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