Inflammation-associated factors for predicting in-hospital mortality in patients with COVID-19
Inflammation-associated factors for predicting in-hospital mortality in patients with COVID-19
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DOI：
10.1002/jmv.26771
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发表时间：
2021-02-23
影响因子：
12.7
通讯作者：
Li, Hua
中科院分区：
文献类型：
--
作者：
Wang, Jun-Hong;Chen, Ru-Dong;Li, Hua
目的是探讨炎症相关因素与院内死亡率之间的关系，并研究哪个因素是2019冠状病毒病患者院内死亡的独立预测因子。该研究包括2020年2月9日至2020年3月30日住院的2019冠状病毒病患者。采用单因素Cox回归分析和最小绝对收缩和选择算子回归（LASSO）选择变量。采用多因素Cox回归分析确定2019冠状病毒病的独立危险因素。研究期间共分析了1135例患者。经临床特征和实验室参数的单因素回归分析，共有35个变量被认为是危险因素（p < 0.05）， LASSO回归分析筛选出7个危险因素供进一步研究。多因素Cox回归显示的6个独立危险因素为肌红蛋白（HR, 5.353, 95% CI, 2.633-10.882, p < 0.001）、c反应蛋白（HR, 2.063, 95% CI, 1.036-4.109, p = 0.039）、中性粒细胞计数（HR, 2.015, 95% CI, 1.154-3.518, p = 0.014）、白细胞介素6 （Il-6， HR, 9.753, 95% CI, 2.952-32.218, p < 0.001）、年龄（HR, 2.016, 95% CI, 1.077-3.773, p = 0.028）、国际标准化比值（HR, 2.595, 95% CI, 1.412-4.769, p = 0.002）。我们的研究结果表明，炎症相关因素与2019冠状病毒病患者的住院死亡率显著相关。c反应蛋白、中性粒细胞计数、白细胞介素6是预测住院死亡率的独立因素，具有较好的独立预测能力。我们相信这些发现可能有助于早期识别死亡风险高的患者，并有助于更好地管理这些患者。
The aim is to explore the relation between inflammation-associated factors and in-hospital mortality and investigate which factor is an independent predictor of in-hospital death in patients with coronavirus disease-2019. This study included patients with coronavirus disease-2019, who were hospitalized between February 9, 2020, and March 30, 2020. Univariate Cox regression analysis and least absolute shrinkage and selection operator regression (LASSO) were used to select variables. Multivariate Cox regression analysis was applied to identify independent risk factors in coronavirus disease-2019. A total of 1135 patients were analyzed during the study period. A total of 35 variables were considered to be risk factors after the univariate regression analysis of the clinical characteristics and laboratory parameters (p < .05), and LASSO regression analysis screened out seven risk factors for further study. The six independent risk factors revealed by multivariate Cox regression were myoglobin (HR, 5.353; 95% CI, 2.633-10.882; p < .001), C-reactive protein (HR, 2.063; 95% CI, 1.036-4.109; p = .039), neutrophil count (HR, 2.015; 95% CI, 1.154-3.518; p = .014), interleukin 6 (Il-6; HR, 9.753; 95% CI, 2.952-32.218; p < .001), age (HR, 2.016; 95% CI, 1.077-3.773; p = .028), and international normalized ratio (HR, 2.595; 95% CI, 1.412-4.769; p = .002). Our results suggested that inflammation-associated factors were significantly associated with in-hospital mortality in coronavirus disease-2019 patients. C-reactive protein, neutrophil count, and interleukin 6 were independent factors for predicting in-hospital mortality and had a better independent predictive ability. We believe these findings may allow early identification of the patients at high risk for death, and can also assist in better management of these patients.