Gastrointestinal Symptoms Associated With Unfavorable Prognosis of COVID-19 Patients: A Retrospective Study.
Gastrointestinal Symptoms Associated With Unfavorable Prognosis of COVID-19 Patients: A Retrospective Study.
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DOI：
10.3389/fmed.2020.608259
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发表时间：
2020
影响因子：
3.9
通讯作者：
Ma D
中科院分区：
文献类型：
--
作者：
Chen R;Yu YL;Li W;Liu Y;Lu JX;Chen F;Zhou Q;Xia ZY;Gao L;Meng QT;Ma D
背景和目的：新冠肺炎在全球范围内的流行对各国的经济和人民生活构成了巨大威胁。新冠肺炎患者最常见的症状是呼吸道症状。然而，胃肠道(GI)症状也可能发生。本研究旨在探讨新冠肺炎患者的胃肠道症状与疾病预后的关系。方法：采用单中心回顾性队列研究，比较有或无胃肠道症状的新冠肺炎患者的疗效。倾向性评分是在给定一组基线测量的协变量的情况下，有特定接触的条件概率(有胃肠道症状的新冠肺炎患者与没有胃肠道症状的患者)。生存估计采用Kaplan-Meier方法，生存差异采用分层对数列检验。为了探讨与ARDS、无创呼吸机治疗、气管插管、气管切开和CRRT相关的胃肠道症状，采用单变量和多变量Cox回归模型。结果：在1113名符合条件的患者中，359名有胃肠道症状的患者和718名没有胃肠道症状的患者有相似的倾向评分，并进入了分析。在新冠肺炎患者中，有胃肠道症状的患者与没有胃肠道症状的患者相比，死亡风险相似，但发生ARDS和无创机械通气的风险更高。结论：在新冠肺炎患者中，胃肠道症状的出现与ARDS、无创机械通气和气管插管的高风险相关，但与死亡率无关。
Background and Aim: The global pandemic of COVID-19 has posed an enormous threat to the economy and people's lives across various countries. Patients with COVID-19 most commonly present with respiratory symptoms. However, gastrointestinal (GI) symptoms can also occur. We aimed to study the relationship between GI symptoms and disease prognosis in patients with COVID-19. Methods: In a single-center and retrospective cohort study, the outcomes in COVID-19 patients with or without GI symptoms were compared. The propensity score is a conditional probability of having a particular exposure (COVID-19 patients with GI symptoms vs. without GI symptoms) given a set of baseline measured covariates. Survival was estimated using the Kaplan-Meier method, and any differences in survival were evaluated with a stratified log-rank-test. To explore the GI symptoms associated with ARDS, non-invasive ventilator treatment, tracheal intubation, tracheotomy, and CRRT, univariable and multivariable COX regression models were used. Results: Among 1,113 eligible patients, 359 patients with GI symptoms and 718 without GI symptoms had similar propensity scores and were included in the analyses. Patients with GI symptoms, as compared with those without GI symptoms, were associated with a similar risk of death, but with higher risks of ARDS, non-invasive mechanical ventilation in COVID-19 patients, respectively. Conclusions: The presence of GI symptoms was associated with a high risk of ARDS, non-invasive mechanical ventilation and tracheal intubation in patients with COVID-19 but not mortality.
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