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分析 COVID-19 重症患者的预后因素。

Analysis of prognostic factors in critically ill patients with COVID-19.

机构信息

Department of Clinical Immunology, Medical University of Bialystok, Bialystok, Poland.

Department of Anaesthesiology and Intensive Care, Medical University of Bialystok, Bialystok, Poland.

出版信息

PLoS One. 2024 Jun 27;19(6):e0302248. doi: 10.1371/journal.pone.0302248. eCollection 2024.

Abstract

The Coronavirus Disease 2019 (COVID-19) has caused a global health crisis. Mortality predictors in critically ill patients remain under investigation. A retrospective cohort study included 201 patients admitted to the intensive care unit (ICU) due to COVID-19. Data on demographic characteristics, laboratory findings, and mortality were collected. Logistic regression analysis was conducted with various independent variables, including demographic characteristics, clinical factors, and treatment methods. The study aimed to identify key risk factors associated with mortality in an ICU. In an investigation of 201 patients comprising non-survivors (n = 80, 40%) and Survivors (n = 121, 60%), we identified several markers significantly associated with ICU mortality. Lower Interleukin 6 and White Blood Cells levels at both 24- and 48-hours post-ICU admission emerged as significant indicators of survival. The study employed logistic regression analysis to evaluate risk factors for in-ICU mortality. Analysis results revealed that demographic and clinical factors, including gender, age, and comorbidities, were not significant predictors of in-ICU mortality. Ventilator-associated pneumonia was significantly higher in Survivors, and the use of antibiotics showed a significant association with increased mortality risk in the multivariate model (OR: 11.2, p = 0.031). Our study underscores the significance of monitoring Il-6 and WBC levels within 48 hours of ICU admission, potentially influencing COVID-19 patient outcomes. These insights may reshape therapeutic strategies and ICU protocols for critically ill patients.

摘要

新型冠状病毒病 2019(COVID-19)引发了全球卫生危机。危重症患者的死亡率预测因素仍在研究中。本回顾性队列研究纳入了 201 名因 COVID-19 入住重症监护病房(ICU)的患者。收集了人口统计学特征、实验室发现和死亡率的数据。使用逻辑回归分析对各种独立变量进行了分析,包括人口统计学特征、临床因素和治疗方法。本研究旨在确定与 ICU 死亡率相关的关键危险因素。在对包括非幸存者(n=80,40%)和幸存者(n=121,60%)的 201 名患者的调查中,我们确定了几个与 ICU 死亡率显著相关的标志物。入住 ICU 后 24 小时和 48 小时白细胞介素 6 和白细胞计数水平较低是存活的显著指标。本研究采用逻辑回归分析评估 ICU 内死亡率的危险因素。分析结果表明,性别、年龄和合并症等人口统计学和临床因素不是 ICU 内死亡率的显著预测因素。幸存者中呼吸机相关性肺炎的发生率明显较高,抗生素的使用在多变量模型中与死亡率增加显著相关(OR:11.2,p=0.031)。我们的研究强调了在 ICU 入住后 48 小时内监测 Il-6 和 WBC 水平的重要性,这可能会影响 COVID-19 患者的结局。这些见解可能会改变对危重症患者的治疗策略和 ICU 方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd90/11210843/a06c3cb9b5f0/pone.0302248.g001.jpg

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