I. Horbachevsky Ternopil National Medical University, Ukraine.
Ternopil Regional Clinical Hospital, Ukraine.
Dent Med Probl. 2024 Mar-Apr;61(2):173-179. doi: 10.17219/dmp/166666.
The Charlson comorbidity index (CCI) has been considered as a valid and reliable tool for predicting poor clinical outcomes and mortality in patients with coronavirus disease 2019 (COVID-19). However, its relationship with the severity of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been thoroughly explored.
The aim of the present study was to identify the impact of the comorbidity burden, quantitatively assessed by applying CCI, on the severity of inpatient community-acquired pneumonia (CAP) caused by SARS-CoV-2.
The study was conducted using the medical records of 208 patients with CAP who had an epidemiological history of a plausible SARS-CoV-2 infection, with positive polymerase chain reaction (PCR) confirmation no later than 1 month before being admitted for inpatient treatment. The CCI was calculated using a custom computer program. The statistical analysis of data was carried out using Statistica, v. 7.0.
Our study found a significant correlation between the comorbidity burden and the severity of CAP caused by SARS-CoV-2. Specifically, we observed a low CCI score in the majority of patients in the pneumonia risk class II and III groups, and a high CCI score ≥3 in the majority of patients in the pneumonia risk class IV group. Moreover, a direct correlation between CCI and age was established. The comorbidities most commonly associated with CAP caused by SARS-CoV-2 were congestive heart failure, moderate to severe liver diseases and diabetes mellitus (DM) with chronic complications.
The use of CCI to evaluate comorbid pathology in hospitalized patients with CAP caused by SARS-CoV-2 can assist the medical staff in developing timely preventive and therapeutic strategies, leading to improved patient prognosis.
Charlson 合并症指数 (CCI) 已被认为是预测 2019 年冠状病毒病 (COVID-19) 患者不良临床结局和死亡率的有效且可靠的工具。然而，其与严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的肺炎严重程度之间的关系尚未得到充分探讨。
本研究旨在确定应用 CCI 定量评估的合并症负担对 SARS-CoV-2 引起的住院社区获得性肺炎 (CAP) 的严重程度的影响。
本研究使用了 208 例 CAP 患者的病历，这些患者具有合理的 SARS-CoV-2 感染的流行病学史，在入院接受住院治疗前 1 个月内，聚合酶链反应 (PCR) 检测结果呈阳性。使用定制的计算机程序计算 CCI。使用 Statistica v. 7.0 对数据进行统计分析。
我们的研究发现，合并症负担与 SARS-CoV-2 引起的 CAP 的严重程度之间存在显著相关性。具体来说，我们观察到肺炎风险分类 II 和 III 组的大多数患者的 CCI 评分较低，而肺炎风险分类 IV 组的大多数患者的 CCI 评分≥3。此外，CCI 与年龄之间存在直接相关性。与 SARS-CoV-2 引起的 CAP 最相关的合并症是充血性心力衰竭、中重度肝疾病和伴有慢性并发症的糖尿病 (DM)。
使用 CCI 评估 SARS-CoV-2 引起的住院 CAP 患者的合并症病理情况可以帮助医务人员制定及时的预防和治疗策略，从而改善患者预后。
