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JAMA Intern Med:武汉新冠肺炎患者急性呼吸窘迫综合征及死亡风险因素研究

2020-03-23 MedSci原创 MedSci原创

高龄新冠肺炎患者发生急性呼吸窘迫综合征和死亡风险较高,而高热患者可导致急性呼吸窘迫综合征风险增加,但同时高热的急性呼吸窘迫综合征患者一般预后较高。使用甲基强的松龙治疗可能有利于急性呼吸窘迫综合征患者预

冠状病毒病2019(COVID-19)是一种新出现的传染病,首次在中国武汉报道,随后在全球传播。近日研究人员就发生急性呼吸窘迫综合征(ARDS)或死亡的COVID-19肺炎患者的临床特点和预后进行描述。
 
本次研究为对中国武汉金银滩医院2019年12月25日至2020年1月26日收治的201例确诊COVID-19肺炎患者的回顾性队列研究。研究的主要终点为ARDS与死亡,还收集和分析了患者的流行病学、人口统计学、临床、实验室、管理、治疗和结果数据。
 
201名患者中,男性患者128例(63.7%),中位年龄51岁。84名患者(41.8%)出现ARDS,其中44名(52.4%)死亡。ARDS患者与未出现ARDS的患者相比,呼吸困难(59.5% vs 25.6%)、伴有高血压(27.4% vs 13.7%)和糖尿病(19.0% vs5.1%)的比例较高。在双变量Cox回归分析中,与ARDS的发生和从ARDS发展到死亡相关的危险因素包括高龄(ARDS HR: 3.26;死亡HR:6.17)、中性粒细胞增多症(1.14;1.08)、器官和凝血功能障碍(如乳酸脱氢酶升高,1.61;1.30)以及D-二聚体[1.03;1.02)。高热(>39°C)增加ARDS风险(HR:1.77),但与死亡风险无关(HR:0.41)。在ARDS患者中,甲基强的松龙治疗可降低死亡风险(HR:0.38)。
 
研究认为,高龄新冠肺炎患者发生急性呼吸窘迫综合征和死亡风险较高,而高热患者可导致急性呼吸窘迫综合征风险增加,但同时高热的急性呼吸窘迫综合征患者一般预后较高。使用甲基强的松龙治疗可能有利于急性呼吸窘迫综合征患者预后。
 
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    2020-03-23 公卫新人

    新冠肺炎,疫情何时才能消失

    0

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    2020-03-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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