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COVID-19和非COVID-19急性呼吸窘迫综合征患者的人口统计学、临床、生化特征及死亡率预测因素的比较分析:一项回顾性队列研究。

Comparative analysis of demographic, clinical, biochemical, and predictors of mortality in COVID-19 and NON-COVID-19 ARDS patients: A retrospective cohort study.

作者信息

Paulo Matheus Furlan, Lago Alessandra Fabiane, Bellíssimo-Rodrigues Fernando, da Silva João Manoel, Basile-Filho Anibal

机构信息

Division of Intensive Care Medicine, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, SP, Brazil.

Division of Health Science, Anhembi Morumbi University, Piracicaba, SP, Brazil.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41851. doi: 10.1097/MD.0000000000041851.

Abstract

The COVID-19 pandemic has brought a significant increase in the incidence of acute respiratory distress syndrome (ARDS). This retrospective study aims to compare the differences in demographic, clinical, and biochemical variables and predictive factors in 2 situations of ARDS cause (COVID-19 vs NON-COVID-19) in patients admitted to the intensive care unit. The Mann-Whitney rank-sum test was performed for quantitative variables, and Fisher exact test for qualitative variables. 115 patients with ARDS were enrolled (53 patients with COVID-19 ARDS and 62 NON-COVID-19 ARDS). The COVID-19 ARDS group consisted of 33 male patients (66.2%), whereas the NON-COVID-19 ARDS group had 25 male patients (40.3%) (P = .0248). The median and interquartile age difference of the COVID-19 ARDS group was 64.0 [52.0-69.5], and non-COVID-19 ARDS was 49.0 [34.0-63.0] (P = .0011). Body mass index, simplified acute physiology score, sequential organ failure assessment, and intensive care unit length of stay, with P-values of .0061, .0002, .0003, and <.0001, respectively (COVID-19 vs NON-COVID-19 ARDS). Diabetes, arterial hypertension, venous thrombosis, and chronic obstructive pulmonary disease had values of <.0001, .0234, .0358, and .0001, respectively. On the other hand, the NON-COVID-19 ARDS group had a greater need for dialysis (P = .0109). The stepwise logistic regression showed that relevant clinical, and demographic characteristics associated with ARDS due to COVID-19, such as male gender, diabetes, chronic obstructive pulmonary disease, and body mass index, were independent prognostic factors of severity in patients with COVID-19 ARDS, compared to NON-COVID-19 ARDS. The overall mortality rate was 62.9% for COVID-19 ARDS and 77.4% for the non-COVID-19 ARDS group (P = .2950). Ventilatory parameters of COVID-19 ARDS and NON-COVID-19 ARDS were similar.

摘要

新型冠状病毒肺炎(COVID-19)大流行使急性呼吸窘迫综合征(ARDS)的发病率显著增加。这项回顾性研究旨在比较入住重症监护病房的ARDS患者在两种病因情况下(COVID-19与非COVID-19)的人口统计学、临床和生化变量及预测因素的差异。对定量变量进行曼-惠特尼秩和检验,对定性变量进行Fisher精确检验。共纳入115例ARDS患者(53例COVID-19相关性ARDS患者和62例非COVID-19相关性ARDS患者)。COVID-19相关性ARDS组有33例男性患者(66.2%),而非COVID-19相关性ARDS组有25例男性患者(40.3%)(P = 0.0248)。COVID-19相关性ARDS组的年龄中位数和四分位间距为64.0[52.0 - 69.5],非COVID-19相关性ARDS组为49.0[34.0 - 63.0](P = 0.0011)。体重指数、简化急性生理学评分、序贯器官衰竭评估及重症监护病房住院时间,P值分别为0.0061、0.0002、0.0003和<0.0001(COVID-19相关性ARDS与非COVID-19相关性ARDS)。糖尿病、动脉高血压、静脉血栓形成和慢性阻塞性肺疾病的P值分别为<0.0001、0.0234、0.0358和0.0001。另一方面,非COVID-19相关性ARDS组对透析的需求更大(P = 0.0109)。逐步逻辑回归显示,与非COVID-19相关性ARDS相比,与COVID-19相关性ARDS相关的临床和人口统计学特征,如男性性别、糖尿病、慢性阻塞性肺疾病和体重指数,是COVID-19相关性ARDS患者严重程度的独立预后因素。COVID-19相关性ARDS组的总体死亡率为62.9%,非COVID-19相关性ARDS组为77.4%(P = 0.2950)。COVID-19相关性ARDS和非COVID-19相关性ARDS的通气参数相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f8f/11936669/988f827d40a7/medi-104-e41851-g001.jpg

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