Department of Critical Care Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, No. 1279, Sanmen Road, Hongkou District, Shanghai, 200434, China.
Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, 200434, China.
BMC Infect Dis. 2024 Aug 20;24(1):842. doi: 10.1186/s12879-024-09621-5.
This study aimed to discover risk factors for death in patients with critical COVID-19 infection in order to identify patients with a higher risk of death at an early stage.
We retrospectively analyzed the clinical data of patients with critical COVID-19 infection from April 2022 to June 2022. Data were collected from the electronic medical records. Propensity matching scores were used to reduce the effect of confounding factors, such as patient baseline variables. Independent risk factors affecting patient prognosis were assessed using univariate logistic regression and multivariate logistic regression analysis. Restricted cubic spline curves were used to assess the relationship between independent and dependent variables.
The data of 132 patients with critical COVID-19 infection were included in the study. Of the 132 patients, 79 survived and 53 died. Among laboratory indicators, patients who died had higher proportions of abnormalities in procalcitonin, aspartate aminotransferase (AST), creatinine, cardiac troponin I, and myoglobin. Univariate and multivariate logistic regression analyses suggested that abnormal AST (OR = 4.98, P = 0.02), creatinine (OR = 7.93, P = 0.021), and myoglobin (OR = 103.08, P = 0.002) were independent risk factors for death. After correction for AST and creatinine, a linear relationship between myoglobin and risk of death in patients was found using restricted cubic splines.
High myoglobin level is an independent risk factor for death and is therefore a prognostic marker in elderly patients with severe COVID-19 infection.
本研究旨在发现重症 COVID-19 感染患者死亡的危险因素，以便早期识别死亡风险较高的患者。
我们回顾性分析了 2022 年 4 月至 2022 年 6 月期间重症 COVID-19 感染患者的临床资料。数据来自电子病历。采用倾向评分匹配法减少患者基线变量等混杂因素的影响。采用单因素 logistic 回归和多因素 logistic 回归分析评估影响患者预后的独立危险因素。采用受限立方样条曲线评估独立和依赖变量之间的关系。
本研究纳入了 132 例重症 COVID-19 感染患者的数据。其中，79 例患者存活，53 例患者死亡。在实验室指标中，死亡患者降钙素原、天门冬氨酸氨基转移酶（AST）、肌酐、心肌肌钙蛋白 I 和肌红蛋白异常比例较高。单因素和多因素 logistic 回归分析提示，AST 异常（OR=4.98，P=0.02）、肌酐异常（OR=7.93，P=0.021）和肌红蛋白异常（OR=103.08，P=0.002）是死亡的独立危险因素。在校正 AST 和肌酐后，采用受限立方样条发现肌红蛋白与患者死亡风险之间存在线性关系。
高肌红蛋白水平是死亡的独立危险因素，因此是老年重症 COVID-19 感染患者的预后标志物。
