Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study.
Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study.
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DOI：
10.1186/s12879-020-05452-2
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发表时间：
2020-10-22
影响因子：
3.7
通讯作者：
Ding S
中科院分区：
文献类型：
--
作者：
Xiong S;Liu L;Lin F;Shi J;Han L;Liu H;He L;Jiang Q;Wang Z;Fu W;Li Z;Lu Q;Chen Z;Ding S
由2019年新型冠状病毒（SARS-CoV-2）引起的一系列急性呼吸道疾病，现称为2019年冠状病毒病（COVID-19），已成为全球大流行病。老年心血管疾病患者更易感染SARS-CoV-2，导致严重后果和病死率升高。同时，心血管疾病在中老年人群中的患病率较高。然而，尽管对COVID-19进行了多项研究，但与之相关的心血管影响仍在很大程度上不清楚。因此，非常需要对COVID-19患者的心血管影响进行具体分析。在这项单中心、回顾性、观察性研究中，入组了116例实验室确诊的COVID-19患者，他们于2020年1月20日至3月8日在中部战区总医院（中国武汉）住院。从电子病历中收集人口统计学数据、基础合并症、临床症状和体征、实验室检查结果、胸部计算机断层扫描、治疗措施和结局数据。比较了非重度和重度病例之间的数据。在116名COVID-19住院患者中，中位年龄为58.5岁（IQR，47.0-69.0），36名（31.0%）为女性。高血压（45例[38.8%]）、糖尿病（19例[16.4%]）和冠心病（17例[14.7%]）是最常见的并存疾病。常见症状包括发热[99例（85.3%）]、干咳（61例[52.6%]）、疲乏（60例[51.7%]）、呼吸困难（52例[44.8%]）、厌食（50例[43.1%]）和胸部不适（50例[43.1%]）。胸部电脑断层扫描的典型影像学表现为局部和/或双侧斑片状阴影。在66例患者（56.9%）中观察到淋巴细胞减少症（淋巴细胞计数，1.0 × 109/L [IQR，0.7-1.3]），在69例患者（59.5%）中观察到乳酸脱氢酶升高（245.5 U/L [IQR，194.3-319.8]）。24例（20.7%）患者发生低钾血症。与非重症病例相比，重症病例年龄偏大（64.0岁[IQR，53.0-76.0] vs 56.0岁[IQR，37.0-64.0]），更有可能患有合并症（35 [63.6%] vs 24 [39.3%]），更有可能发生急性心脏损伤（19例[34.5%] vs 4例[6.6%]）、急性心力衰竭（18例[32.7%] vs 3例[4.9%]）和ARDS（20例[36.4%] vs 0例[0%]）。住院期间，重症患者新发高血压患病率（55.2%）显著高于非重症患者（19.0%）。在这项单中心、回顾性、观察性研究中，我们发现SARS-CoV-2感染更容易发生在有心血管合并症的中老年人群中。心血管并发症，包括新发高血压和心脏损伤，在COVID-19重症患者中很常见。迫切需要对COVID-19的心血管受累进行更详细的研究，以进一步了解这种疾病。
A cluster of acute respiratory illness, now known as Corona Virus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged population with cardiovascular diseases are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases have a high prevalence in the middle-aged and elderly population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need. In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases. Of 116 hospitalized patients with COVID-19, the median age was 58.5 years (IQR, 47.0–69.0), and 36 (31.0%) were female. Hypertension (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever [99 (85.3%)], dry cough (61 [52.6%]), fatigue (60 [51.7%]), dyspnea (52 [44.8%]), anorexia (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia (lymphocyte count, 1.0 × 109/L [IQR, 0.7–1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3–319.8]) in 69 patients (59.5%). Hypokalemia occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0–76.0] vs 56.0 years [IQR, 37.0–64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence of new onset hypertension was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones. In this single-centered, retrospective, observational study, we found that the infection of SARS-CoV-2 was more likely to occur in middle and aged population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension and heart injury were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease.
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DOI：
10.1186/cc11454
发表时间：
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期刊：
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影响因子：
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作者：
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