Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study.
Clinical characteristics and laboratory biomarkers changes in COVID-19 patients requiring or not intensive or sub-intensive care: a comparative study.
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DOI：
10.1186/s12879-020-05647-7
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发表时间：
2020-12-09
影响因子：
3.7
通讯作者：
Sasset L
中科院分区：
文献类型：
--
作者：
Cattelan AM;Di Meco E;Trevenzoli M;Frater A;Ferrari A;Villano M;Gomiero F;Carretta G;Sasset L
识别严重新型冠状病毒病（COVID-19）的风险因素有助于确定哪些患者可能受益于先进的支持性护理。该研究描述了因非危重临床表现而入住普通病房的COVID-19患者，旨在分析转入重症监护室（ICU）和/或亚重症监护室（SICU）的患者与未转入重症监护室的患者之间的差异。这项观察性回顾性研究包括所有在传染病科住院的COVID-19患者。收集临床、实验室、放射学和治疗数据。主要结局是住院期间需要转入ICU和/或SICU的复合终点。不需要转移的患者定义为第1组;转移至ICU和/或SICU的患者定义为第2组。比较两组患者第1次、第3次和末次测量时的人口统计学、临床特征和实验室检查结果。303人被列入。中位年龄为62岁。69例患者（22.8%）符合主要结局，定义为第2组。总病死率为6.8%。第2组患者主要为男性（76.8% vs.55.1%，P < 0.01），病死率较高（14.5%对3.8%，P <0.01），（72.4% vs. 44%，p <0.01）和糖尿病（31.9% vs. 21%，p = 0.04），并且更可能出现干咳（49.3% vs. 25.2%，p < 0.01）。总体而言，入院时的胸部X线检查显示63.2%的患者提示肺炎，第2组在住院期间更有可能出现病理学结果（72.7% vs. 17.2%，p = 0.01）。入院时，第2组的中性粒细胞计数、转氨酶和C反应蛋白显著升高。在第3次测量时，第2组的中性粒细胞计数、肝脏炎症标志物和C反应蛋白持续升高。第1组从入院到随访拭子阴性的持续时间较短（20 vs. 35天，p < 0.01）。合并症的存在和异常实验室检查结果的持续观察应被视为临床恶化的诱发因素。在线版本包含补充材料，可通过10.1186/s12879-020-05647-7获得。
Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01). The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening. The online version contains supplementary material available at 10.1186/s12879-020-05647-7.
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影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
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5.8
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DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
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通讯作者：
Ferguson, Neil M
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影响因子：
120.7
作者：
Wang, Dawei;Hu, Bo;Peng, Zhiyong
通讯作者：
Peng, Zhiyong