感染SARS-CoV2个体发生肺栓塞的危险因素——一项单中心回顾性研究

Risk Factors for Pulmonary Embolism in Individuals Infected with SARS-CoV2-A Single-Centre Retrospective Study.

作者信息

Herlo Alexandra, Marinescu Adelina Raluca, Cut Talida Georgiana, Laza Ruxandra, Oancea Cristian Iulian, Manolescu Diana, Hogea Elena, Porosnicu Tamara Mirela, Sincaru Suzana Vasilica, Dumache Raluca, Ispas Sorina, Nelson Twakor Andreea, Nicolae Maria, Lazureanu Voichita Elena

机构信息

Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.

Department XIII, Discipline of Pneumology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania.

出版信息

Biomedicines. 2024 Apr 1;12(4):774. doi: 10.3390/biomedicines12040774.

Abstract

The emergence of SARS-CoV2 has presented itself as a significant global health crisis. The prevalence of thrombotic events is known to be high in these patients, affecting various organ systems, sometimes leading to cutaneous thrombosis, pulmonary embolism (PE), stroke, or coronary thrombosis. The available evidence suggests that thromboembolism, hypercoagulability, and the excessive production of proinflammatory cytokines play a significant role in the development of multiorgan failure. This retrospective single-centre study was conducted at "Victor Babes" University of Medicine and Pharmacy from Timisoara, Romania, involving a total of 420 patients diagnosed with COVID-19. We separated them into a CONTROL group that included 319 patients, and an intervention group (PE) with 101 patients that, subsequent to infection with the virus, developed pulmonary embolism. The study included the reporting of demographic data, laboratory findings, and comorbidities. Out of a total of 420 patients, 24% experienced pulmonary embolism, while 21.42% died. Arterial thrombotic events were found to be associated with factors such as age, cardiovascular disease, levels of white blood cells, D-dimers, and albumin in the blood. The findings of the study indicate that there is an independent association between pulmonary thrombosis and hypertension (odds ratio (OR): 1.1; 95% confidence interval (CI): 0.7 to 1.7; = 0.6463), cancer (OR: 1.1; 95% CI: 0.6 to 2.3; = 0.6014), and COPD (OR: 1.2; 95% CI: 0.6 to 2.3; = 0.4927). On the other hand, there is a stronger correlation between PE and obesity (OR: 2.8; 95% CI: 1.7 to 4.6; < 0.0001), diabetes (OR: 3.3; 95% CI: 2 to 5.3; < 0.0001), and dyslipidemia (OR: 3.6; 95% CI: 2.3 to 5.8; < 0.0001) in a multivariable regression logistic model. Patients diagnosed with severe forms of COVID-19 display a comparable incidence of arterial thrombotic events, which have been linked to poor survival rates.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV2)的出现已成为一场重大的全球健康危机。已知这些患者中血栓形成事件的发生率很高,会影响各个器官系统,有时会导致皮肤血栓形成、肺栓塞(PE)、中风或冠状动脉血栓形成。现有证据表明,血栓栓塞、高凝状态以及促炎细胞因子的过度产生在多器官功能衰竭的发展中起重要作用。这项回顾性单中心研究在罗马尼亚蒂米什瓦拉的“维克托·巴比什”医科药科大学进行,共纳入420例确诊为新型冠状病毒肺炎(COVID-19)的患者。我们将他们分为一个包含319例患者的对照组和一个有101例患者的干预组(PE组),该干预组患者在感染病毒后发生了肺栓塞。该研究包括人口统计学数据、实验室检查结果和合并症的报告。在总共420例患者中,24%发生了肺栓塞,21.42%死亡。发现动脉血栓形成事件与年龄、心血管疾病、白细胞水平、血液中的D-二聚体和白蛋白等因素有关。该研究结果表明,肺血栓形成与高血压(比值比(OR):1.1;95%置信区间(CI):0.7至1.7;P = 0.6463)、癌症(OR:1.1;95% CI:0.6至2.3;P = 0.6014)和慢性阻塞性肺疾病(COPD)(OR:1.2;95% CI:0.6至2.3;P = 0.4927)之间存在独立关联。另一方面,在多变量回归逻辑模型中,PE与肥胖(OR:2.8;95% CI:1.7至4.6;P < 0.0001)、糖尿病(OR:3.3;95% CI:2至5.3;P < 0.0001)和血脂异常(OR:3.6;95% CI:2.3至5.8;P < 0.0001)之间存在更强的相关性。诊断为重症COVID-19的患者动脉血栓形成事件的发生率相当,这与生存率低有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ab1/11048050/ee0e32a8e65f/biomedicines-12-00774-g001.jpg

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