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Neurology:神经系统综合征预测COVID-19患者住院死亡率

2020-12-22 MedSci原创 MedSci原创

入院时发生精神错乱或卒中预示着院内死亡风险升高,而与疾病的严重程度无关。尽管其他生物标志物因素也可以预测死亡率,但识别和治疗此类患者的措施对于降低COVID-19患者的整体死亡率可能很重要。

SARS-Cov2病毒的表现形式是蛋白质,几乎影响每个器官系统。但是,神经系统受累及其对疾病结局的影响的尚未明确。近日,神经病学领域权威杂志Neurology上发表了一篇研究文章,该研究旨在明确神经系统综合症是否与住院死亡率增加相关。

研究人员将581例确诊SARS-Cov2感染、神经系统受累和脑成像的住院患者与非神经系统受累的COVID-19住院患者进行比较,确定了四种神经系统表现形式-急性卒中、新发或复发性癫痫发作、正常成像导致的精神改变和神经-COVID-19复合事件。分析入院时存在的因素,作为院内死亡的潜在预测因素,包括社会人口统计学变量、既往合并症、生命体征、实验室检查结果和神经系统表现的形式。研究人员将重要的预测因素纳入疾病严重程度评分,并将具有神经学表现的患者与年龄和疾病严重程度相同的患者进行配对,以评估死亡风险。

在确诊的SARS-Cov2感染患者中,有4711名患者在6周时间内被纽约市医疗系统收治。在这些患者中,有581名(12%)患者出现了神经系统症状,需要进行神经成像检查。将这些患者与同期入院的年龄和疾病严重程度匹配的1743名非神经系统受累的COVID-19患者进行比较。精神错乱(n=258,p=0.04,OR为1.39,95%CI为1.04-1.86)或经影像学证实为卒中(n=55,p=0.001,OR为3.1,95%CI为1.65-5.92)的患者死亡风险高于年龄和严重程度匹配的对照者。

由此可见,入院时发生精神错乱或卒中预示着院内死亡风险升高,而与疾病的严重程度无关。尽管其他生物标志物因素也可以预测死亡率,但识别和治疗此类患者的措施对于降低COVID-19患者的整体死亡率可能很重要。

原始出处:

Emad Nader Eskandar.et al.Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19.Neurology.2020.https://doi.org/10.1212/WNL.0000000000011356

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    2021-05-26 yinhl1978
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    2020-12-22 神盾医疗局局长Jack

    入院时发生精神错乱或卒中预示着院内死亡风险升高,而与疾病的严重程度无关。尽管其他生物标志物因素也可以预测死亡率,但识别和治疗此类患者的措施对于降低COVID-19患者的整体死亡率可能很重要

    0

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