Epidemiological & clinical characteristics & early outcome of COVID-19 patients in a tertiary care teaching hospital in India: A preliminary analysis.
Epidemiological & clinical characteristics & early outcome of COVID-19 patients in a tertiary care teaching hospital in India: A preliminary analysis.
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DOI：
10.4103/ijmr.ijmr_2890_20
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Subramaniam R
中科院分区：
文献类型：
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作者：
Kayina CA;Haritha D;Soni L;Behera S;Nair PR;Gouri M;Girish K;Deeparaj L;Maitra S;Anand RK;Ray BR;Baidya DK;Subramaniam R
在这项研究中，我们描述了来自印度新德里三级护理教学医院的2019年冠状病毒病（COVID-19）患者的流行病学数据、合并症、临床症状、疾病严重程度和早期结局。在这项前瞻性观察性研究的初步分析中，纳入了所有进入该研究所筛选重症监护室（ICU）的成年患者，这些患者符合WHO对COVID-19的病例定义，并通过逆转录-聚合酶链反应证实患有SARS-CoV-2感染。评估人口统计学、临床数据和24 h结局。对235例患者的初步分析显示，平均年龄为50.7±15.1岁，68.1%为男性。发热（68.1%）、咳嗽（59.6%）、气促（71.9%）是最常见的临床症状。高血压（28.1%）和糖尿病（23.3%）是最常见的合并症。入住ICU时，轻度、中度、重度和危重症患者分别为18.3%、32.3%、31.1%和18.3%。在入院后24小时内，需要任何形式氧疗、高流量鼻插管氧疗和有创机械通气的患者比例（95%置信区间）分别为77%、21.7%和25.5%。24小时ICU死亡率为8.5%，死亡者呼吸频率较高（P<0.01，n=198）和基线血氧饱和度较低（P<0.001，n=198），基线血清乳酸水平较高与存活者相比，死亡组的白细胞总数（P <0.001，n=186）、中性粒细胞绝对计数（P <0.001，n=132）、凝血酶原时间（P<0.05，n=54）和国际标准化比值（P <0.05，n = 54）显著降低（P<0.01，n=122）。近一半的患者表现为严重和危重疾病，入院时需要高流量鼻氧或有创机械通气。当前呼吸道疾病的严重程度、血液学参数和乳酸盐而不是年龄或合并症的存在预测了24小时内的早期死亡。
In this study we describe the epidemiological data, comorbidities, clinical symptoms, severity of illness and early outcome of patients with coronavirus disease 2019 (COVID-19) from a tertiary care teaching hospital in New Delhi, India. In this preliminary analysis of a prospective observational study, all adult patients admitted to the screening intensive care unit (ICU) of the institute who fulfilled the WHO case definition of COVID-19 and confirmed to have SARS-CoV-2 infection by reverse transcription-polymerase chain reaction were included. Demographics, clinical data and 24 h outcome were assessed. The preliminary analysis of 235 patients revealed that the mean age was 50.7±15.1 yr and 68.1 per cent were male. Fever (68.1%), cough (59.6%) and shortness of breath (71.9%) were the most common presenting symptoms. Hypertension (28.1%) and diabetes mellitus (23.3%) were the most common associated comorbid illnesses. Patients with mild, moderate, severe and critical illness were 18.3, 32.3, 31.1 and 18.3 per cent, respectively, at the time of ICU admission. The proportions (95% confidence interval) of patients requiring any form of oxygen therapy, oxygen therapy by high-flow nasal cannula and invasive mechanical ventilation were 77, 21.7 and 25.5 per cent, respectively, within 24 h of hospital admission. The 24 h ICU mortality was 8.5 per cent, and non-survivors had higher respiratory rate (P<0.01, n=198) and lower baseline oxyhaemoglobin saturation (P<0.001, n=198) at presentation and higher baseline serum lactate (P<0.01, n=122), total leucocyte count (P<0.001, n=186), absolute neutrophil count (P<0.001, n=132), prothrombin time (P<0.05, n=54) and INR (P<0.05, n=54) compared to survivors. Nearly half of the patients presented with severe and critical disease and required high-flow nasal oxygen or invasive mechanical ventilation at admission. Severity of the presenting respiratory illness, haematological parameters and lactate rather than age or presence of comorbidity predicted early death within 24 h.