Elderly Male With Cardiovascular-Related Comorbidities Has a Higher Rate of Fatal Outcomes: A Retrospective Study in 602 Patients With Coronavirus Disease 2019.
Elderly Male With Cardiovascular-Related Comorbidities Has a Higher Rate of Fatal Outcomes: A Retrospective Study in 602 Patients With Coronavirus Disease 2019.
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患有心血管相关合并症的老年男性死亡率较高：对 602 名 2019 年冠状病毒病患者进行的回顾性研究
DOI：
10.3389/fcvm.2021.680604
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发表时间：
2021
影响因子：
3.6
通讯作者：
Yang M
中科院分区：
文献类型：
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作者：
Zhan XY;Li L;Hu Y;Li Q;Kong H;Ng MHL;Chen C;He Y;Huang B;Yang M
患有冠状病毒病的老年人2019年表现出更高的致命结局比率(新冠肺炎)。然而，血液学指标的临床意义和潜在的并存在新冠肺炎的进展和结果中的描述仍然不确定。回顾分析武汉市汉口医院中国医院2020年1月14日至2020年2月29日收治的602例临床转归明确的新冠肺炎患者。602例新冠肺炎患者中，539例已出院，63例在医院死亡。死亡组白细胞和中性粒细胞计数较高，而淋巴细胞和血小板计数较低。死亡患者活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)延长，D-二聚体和C反应蛋白水平升高。我们的观察表明，这些参数可以作为潜在的预测结果的致命结果和出院组。中性粒细胞计数和D-二聚体水平越高，淋巴细胞水平越低，住院时间越长。多因素COX回归分析显示，中性粒细胞计数高、PT延长、淋巴细胞计数低是新冠肺炎患者的危险因素。此外，我们还发现淋巴细胞计数较低和C反应蛋白水平较高与老年组和那些患有心血管相关合并症的人有关。幸存者和死亡者之间显著不同的血液学特征支持，新冠肺炎患者不同的血液学特征将决定不同的预后，作为判断康复或死亡的指标。淋巴细胞减少和侵袭性炎症反应可能是老年男性死亡的主要原因，特别是那些患有心血管相关合并症的人。
Elderly with comorbidities have shown a higher rate of fatal outcomes when suffering coronavirus disease 2019 (COVID-19). However, a delineation of clinical significances of hematologic indices and underlying comorbidities in the progression and outcome of COVID-19 remains undefined. Six hundred two COVID-19 patients with established clinical outcomes (discharged or deceased) from Hankou Hospital of Wuhan, China between January 14, 2020 and February 29, 2020 were retrospectively analyzed. Of the 602 patients with COVID-19, 539 were discharged and 63 died in the hospital. The deceased group showed higher leukocyte and neutrophil counts but lower lymphocyte and platelet counts. Longer activated partial thromboplastin time (APTT) and prothrombin time (PT), as well as higher D-dimer and C-reactive protein levels, were found in non-survivors. Our observations suggest that these parameters could serve as potential predictors for the fatal outcome and in the discharged group. A higher neutrophil count and D-dimer level but lower lymphocyte were associated with a longer duration of hospitalization. A multivariable Cox regression analysis showed that higher neutrophil count, prolonged PT, and low lymphocyte count were risk factors for patients with COVID-19. Also, we found an association of lower lymphocyte count and higher C-reactive protein levels with the elderly group and those with cardiovascular-related comorbidities. The significantly different hematologic profiles between survivors and non-survivors support that distinct hematologic signatures in COVID-19 patients will dictate different outcomes as a prognostic marker for recovery or fatality. Lymphopenia and aggressive inflammatory response might be major causes for fatal outcomes in the elderly male and especially those with cardiovascular-related comorbidities.
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DOI：
10.1111/jth.14817
发表时间：
2020-05
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
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影响因子：
15.1
作者：
Shah, Akshay;Donovan, Killian;McKechnie, Stuart R.
通讯作者：
McKechnie, Stuart R.
影响因子：
20.3
作者：
Manne, Bhanu Kanth;Denorme, Frederik;Campbell, Robert A.
通讯作者：
Campbell, Robert A.
影响因子：
100.3
作者：
Merad, Miriam;Martin, Jerome C.
通讯作者：
Martin, Jerome C.
DOI：
10.1111/jth.14854
发表时间：
2020-07
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
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