Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: a multicenter nested case-control study
Lactate dehydrogenase and susceptibility to deterioration of mild COVID-19 patients: a multicenter nested case-control study
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DOI：
10.1186/s12916-020-01633-7
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发表时间：
2020-06-03
期刊：
影响因子：
9.3
通讯作者：
Zhang, Wenhong
中科院分区：
文献类型：
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作者：
Shi, Jichan;Li, Yang;Zhang, Wenhong
2019冠状病毒病（COVID-19）在4个月内感染了400多万人。目前迫切需要正确识别高风险病例，即使他们入院时表现为轻度疾病，也更有可能恶化。MethodsA多中心巢式病例对照研究在中国的四家定点医院进行，招募确诊的COVID-19患者，入院时病情较轻。结果自2020年1月17日至2020年2月1日，共入组85例确诊新冠肺炎患者，其中进展组16例，稳定组69例。与稳定轻度组（n=69）相比，进展组（n=16）中的患者更可能为老年男性，表现为呼吸困难、高血压以及乳糖酶脱氢酶和C反应蛋白水平较高。在多因素Logistic回归分析中，高龄（比值比[OR]，1.012; 95%置信区间[CI]，1.020-1.166; P=0.011）和较高水平的乳糖酶脱氢酶（OR为1.012; 95% CI为1.001-1.024; P=0.038）与轻度COVID-1患者的病情加重独立相关。结论高龄和高LDH水平是轻度COVID-19患者病情加重的独立危险因素。在轻症患者中，临床医生应更多地关注老年患者或LDH水平高的患者。
BackgroundCoronavirus disease 2019 (COVID-19) has infected more than 4 million people within 4 months. There is an urgent need to properly identify high-risk cases that are more likely to deteriorate even if they present mild diseases on admission.MethodsA multicenter nested case-control study was conducted in four designated hospitals in China enrolling confirmed COVID-19 patients who were mild on admission. Baseline clinical characteristics were compared between patients with stable mild illness (stable mild group) and those who deteriorated from mild to severe illness (progression group).ResultsFrom Jan 17, 2020, to Feb 1, 2020, 85 confirmed COVID-19 patients were enrolled, including 16 in the progression group and 69 in the stable mild group. Compared to stable mild group (n=69), patients in the progression group (n=16) were more likely to be older, male, presented with dyspnea, with hypertension, and with higher levels of lactase dehydrogenase and c-reactive protein. In multivariate logistic regression analysis, advanced age (odds ratio [OR], 1.012; 95% confidence interval [CI], 1.020-1.166; P=0.011) and the higher level of lactase dehydrogenase (OR, 1.012; 95% CI, 1.001-1.024; P=0.038) were independently associated with exacerbation in mild COVID-19 patients.ConclusionAdvanced age and high LDH level are independent risk factors for exacerbation in mild COVID-19 patients. Among the mild patients, clinicians should pay more attention to the elderly patients or those with high LDH levels.