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COVID-19 死亡患者与康复患者的临床、实验室和影像学检查结果比较分析。

Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered Patients.

机构信息

Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Kathmandu, Nepal.

Department of Microbiology, Nepal Armed Police Force Hospital, Kathmandu, Nepal. Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2023;21(84):415-421.

Abstract

Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age: 66 (53-76) years, male: 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age: 51 (38-61) years, male: 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple comorbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients.

摘要

背景

随着与 COVID-19 相关的住院死亡率不断上升,了解 2019 年冠状病毒病(COVID-19)的特定指标变得尤为重要。

目的

本病例对照研究比较了死亡和康复的 COVID-19 患者的临床、实验室和影像学表现,并确定了与死亡患者相关的显著生物标志物。

方法

使用 SPSS 版本 17.0 对 2021 年 3 月至 12 月期间在尼泊尔武装警察部队医院的 COVID-19 专用病房住院的 COVID-19 患者的临床、实验室和影像学检查结果进行分析,统计显著性水平设为 p<0.05。

结果

共纳入 187 例 COVID-19 患者,包括死亡[ n=95,中位数(四分位距,IQR)年龄:66(53-76)岁,男性:61(64.2%)(p=0.024)]和康复[ n=92,中位数(IQR)年龄:51(38-61)岁,男性:44(47.8%)]。与康复的 COVID-19 患者相比,死亡患者的呼吸(20 与 29.5 次/分钟)和脉搏(83 与 86 次/分钟)率更高;合并多种合并症(≥2 种)(11.9%与 32.6%)(p<0.001);碱性磷酸酶(ALP)、总蛋白(TP)、白蛋白、淋巴细胞、单核细胞、嗜酸性粒细胞、血红蛋白明显降低(p<0.05),血糖、乳酸脱氢酶(LDH)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、白细胞、中性粒细胞、D-二聚体和 C 反应蛋白(CRP)明显升高(p<0.05);胸部异常包括双侧(p<0.001)、外周(p<0.001)间质性(p<0.001)和磨玻璃密度(GGO)(p=0.002)。

结论

年龄较大、男性、呼吸和脉搏率增加、合并多种合并症、ALP、TP、白蛋白、淋巴细胞、单核细胞、嗜酸性粒细胞、血红蛋白水平降低、血糖、LDH、ALT、AST、白细胞、中性粒细胞、D-二聚体、CRP 水平升高、胸部 X 线显示双侧、外周间质性和 GGO 异常是与 COVID-19 死亡患者相关的显著指标。

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