Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study.
Clinical characteristics and survival analysis in critical and non-critical patients with COVID-19 in Wuhan, China: a single-center retrospective case control study.
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DOI：
10.1038/s41598-020-74465-3
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发表时间：
2020-10-16
影响因子：
4.6
通讯作者：
Zhang S
中科院分区：
文献类型：
--
作者：
Tian R;Wu W;Wang C;Pang H;Zhang Z;Xu H;Luo Q;Gao P;Shi J;Li W;Qian H;Guo F;Li T;Liu Z;Wang J;Zhou X;Qin Y;Yan X;Zhang S
自2019年底中国新冠肺炎疫情爆发以来，全球经历了一场由SARS-CoV-2引发的大规模疫情。新冠肺炎患者的流行病学和临床病程已有报道，但对危重患者的特点、预测危险因素和结局分析较少。在这项单中心回顾性病例对照研究中，纳入了90名在中国武汉同济医院住院的成人患者。获得危重和非危重患者的人口学、临床、实验室检查和治疗数据并进行比较。我们发现危重患者的SOFA评分和qSOFA评分均高于非危重患者。危重患者淋巴细胞和血小板计数降低，d -二聚体升高，纤维蛋白原降低，高敏c反应蛋白（hsCRP）和白细胞介素-6（IL-6）升高。危重患者接受抗生素、抗凝、皮质类固醇和氧疗的治疗多于非危重患者。多变量回归分析显示，危重患者的qSOFA评分和IL-6水平升高相关。抗生素使用和抗凝与住院死亡率降低相关。危重分组对院内死亡的影响较大。危重患者的临床病程更为严重。qSOFA评分和IL-6升高是危重症的危险因素。非关键分组，阳性抗生素应用，抗凝可能有利于患者生存。
Since the outbreak of COVID-19 in China at the end of 2019, the world has experienced a large-scale epidemic caused by the SARS-CoV-2. The epidemiological and clinical course of COVID-19 patients has been reported, but there have been few analyses about the characteristics, predictive risk factors, and outcomes of critical patients. In this single-center retrospective case–control study, 90 adult inpatients hospitalized at Tongji Hospital (Wuhan, China) were included. Demographic, clinical, laboratory tests, and treatment data were obtained and compared between critical and non-critical patients. We found that compared with non-critical patients, the critical patients had higher SOFA score and qSOFA scores. Critical patients had lower lymphocyte and platelet count, elevated D-dimer, decreased fibrinogen, and elevated high-sensitivity C-reactive protein (hsCRP), and interleukin-6(IL-6). More critical patients received treatment including antibiotics, anticoagulation, corticosteroid, and oxygen therapy than non-critical ones. Multivariable regression showed higher qSOFA score and elevation of IL-6 were related to critical patients. Antibiotic usage and anticoagulation were associated with decreased in-hospital mortality. And critical grouping contributed greatly to in-hospital death. Critical COVID-19 patients have a more severe clinical course. qSOFA score and elevation of IL-6 are risk factors for critical condition. Non-critical grouping, positive antibiotic application, and anticoagulation may be beneficial for patient survival.
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DOI：
10.1001/jama.2016.0288
发表时间：
2016-02-23
期刊：
JAMA
影响因子：
--
作者：
Seymour CW;Liu VX;Iwashyna TJ;Brunkhorst FM;Rea TD;Scherag A;Rubenfeld G;Kahn JM;Shankar-Hari M;Singer M;Deutschman CS;Escobar GJ;Angus DC
通讯作者：
Angus DC
DOI：
10.1056/nejmoa2022926
发表时间：
2020-11-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
RECOVERY Collaborative Group;Horby P;Mafham M;Linsell L;Bell JL;Staplin N;Emberson JR;Wiselka M;Ustianowski A;Elmahi E;Prudon B;Whitehouse T;Felton T;Williams J;Faccenda J;Underwood J;Baillie JK;Chappell LC;Faust SN;Jaki T;Jeffery K;Lim WS;Montgomery A;Rowan K;Tarning J;Watson JA;White NJ;Juszczak E;Haynes R;Landray MJ
通讯作者：
Landray MJ
影响因子：
120.7
作者：
Raith, Eamon P.;Udy, Andrew A.;Pilcher, David V.
通讯作者：
Pilcher, David V.
中国武汉市 138 例 2019 新型冠状病毒感染肺炎住院患者的临床特征。
影响因子：
120.7
作者：
Wang, Dawei;Hu, Bo;Peng, Zhiyong
通讯作者：
Peng, Zhiyong
影响因子：
168.9
作者：
Chen, Nanshan;Zhou, Min;Zhang, Li
通讯作者：
Zhang, Li