Gomez-Paz Sandra, Lam Eric, Fogel Joshua, Rubinstein Sofia
Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Department of Management, Marketing and Entrepreneurship, Brooklyn College, Brooklyn, NY, USA.
J Community Hosp Intern Med Perspect. 2024 Nov 2;14(6):43-49. doi: 10.55729/2000-9666.1422. eCollection 2024.
Impaired consciousness is associated with complications and mortality in COVID-19 patients. We study factors associated with impaired consciousness as measured by the Glasgow Coma Scale (GCS) in COVID-19 patients.
This is a retrospective study of 604 patients with COVID-19 in the metropolitan New York City area. We study the association of demographics, comorbidity, disease severity, treatment management, and laboratory measurements with both GCS nadir during hospitalization and GCS at discharge.
Age was significantly associated with severe GCS nadir during hospitalization and at hospital discharge. Body mass index comorbidity was significantly associated with severe GCS at hospital discharge. Sedation treatment was significantly associated with both moderate and severe GCS nadir during hospitalization. Glucose nadir was significantly associated with severe GCS nadir during hospitalization. Sodium level at admission was associated with decreased relative risk while BUN peak level during hospitalization was associated with increased relative risk for severe GCS on discharge.
We found that factors from demographics, comorbidity, treatment management, and laboratory measurements were associated with GCS while disease severity was not significantly associated with GCS. These findings can guide clinicians for treatment approaches for the early identification of impaired consciousness and its degrees of severity in COVID-19 patients.
意识障碍与新冠肺炎患者的并发症及死亡率相关。我们研究了以格拉斯哥昏迷量表（GCS）衡量的新冠肺炎患者意识障碍的相关因素。
这是一项对纽约市大都市区604例新冠肺炎患者的回顾性研究。我们研究了人口统计学、合并症、疾病严重程度、治疗管理及实验室检测指标与住院期间GCS最低点及出院时GCS的相关性。
年龄与住院期间及出院时严重的GCS最低点显著相关。体重指数合并症与出院时严重的GCS显著相关。镇静治疗与住院期间中度及严重的GCS最低点均显著相关。血糖最低点与住院期间严重的GCS最低点显著相关。入院时钠水平与相对风险降低相关，而住院期间血尿素氮峰值水平与出院时严重GCS的相对风险增加相关。
我们发现，人口统计学、合并症、治疗管理及实验室检测指标等因素与GCS相关，而疾病严重程度与GCS无显著相关性。这些发现可为临床医生在新冠肺炎患者中早期识别意识障碍及其严重程度的治疗方法提供指导。
