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影响新型冠状病毒肺炎患者严重程度、死亡率及入住重症监护病房的危险因素:1075例系列病例研究

Risk Factors Affecting the Severity, Mortality, and Intensive Care Unit Admission of COVID-19 Patients: A Series of 1075 Cases.

作者信息

Narin Çopur Ecem, Ergün Dilek, Ergün Recai, Atik Serap, Türk Dağı Hatice, Körez Muslu Kazım

机构信息

Department of Pulmonary Medicine, Dr. Yaşar Eryılmaz Doğubeyazıt State Hospital, Ağrı 04402, Turkey.

Department of Pulmonary Medicine, Faculty of Medicine, Selcuk University, Konya 42130, Turkey.

出版信息

Viruses. 2025 Mar 17;17(3):429. doi: 10.3390/v17030429.

Abstract

BACKGROUND

The clinical spectrum of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is broad; it can range from asymptomatic cases to mild upper respiratory tract illness, respiratory failure, and severe multiorgan failure resulting in death. Therefore, it is important to identify the clinical course of the disease and the factors associated with mortality.

OBJECTIVE

The aim of this study is to identify the risk factors associated with the severity of the disease, intensive care unit admission, and mortality in COVID-19 patients.

METHODS

A total of 1075 patients with clinical and radiological findings compatible with COVID-19 pneumonia and positive SARS-CoV-2 PCR were selected and retrospectively screened. All included patients were classified according to the 7th edition of the 2019 Coronavirus Disease Guidelines published by the National Health Commission of China.

RESULTS

It was observed that elevated white blood count (WBC) increased the severity of COVID-19 by 3.26 times and the risk of intensive care unit (ICU) admission by 3.47 times. Patients with high D-dimer levels had a 91% increased risk, and those with high fibrinogen levels had a 2.08 times higher risk of severe disease. High C-reactive protein (CRP) values were found to increase disease severity by 6.89 times, mortality by 12.84 times, and ICU admission by 3.37 times.

CONCLUSIONS

Identifying the factors associated with disease severity, ICU admission, and mortality in COVID-19 patients could help reduce disability and mortality rates in pandemics.

摘要

背景

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的临床谱广泛;范围可从无症状病例到轻度上呼吸道疾病、呼吸衰竭以及导致死亡的严重多器官衰竭。因此,确定该疾病的临床病程以及与死亡率相关的因素很重要。

目的

本研究的目的是确定与2019冠状病毒病(COVID-19)患者疾病严重程度、入住重症监护病房及死亡率相关的危险因素。

方法

共选择1075例临床和影像学表现符合COVID-19肺炎且SARS-CoV-2聚合酶链反应(PCR)呈阳性的患者,并进行回顾性筛查。所有纳入患者均根据中国国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(第七版)》进行分类。

结果

观察到白细胞计数(WBC)升高使COVID-19的严重程度增加3.26倍,入住重症监护病房(ICU)的风险增加3.47倍。D-二聚体水平高的患者患重症的风险增加91%,纤维蛋白原水平高的患者患重症的风险高2.08倍。发现高C反应蛋白(CRP)值使疾病严重程度增加6.89倍,死亡率增加12.84倍,入住ICU的风险增加3.37倍。

结论

确定与COVID-19患者疾病严重程度、入住ICU及死亡率相关的因素有助于降低大流行中的残疾率和死亡率。

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