Clinical characteristics and treatment of critically ill patients with COVID-19 in Hebei
Clinical characteristics and treatment of critically ill patients with COVID-19 in Hebei
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DOI：
10.21037/apm-20-1273
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发表时间：
2020-07-01
影响因子：
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通讯作者：
Hu, Zhenjie
中科院分区：
文献类型：
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作者：
Chen, Yuhong;Zhang, Kun;Hu, Zhenjie
背景：2019 年 12 月，中国武汉出现了 2019 年新型冠状病毒病（COVID-19）。我们的目的是阐明中国河北省 COVID-19 重症患者的流行病学、实验室检查、影像学表现和治疗情况。方法：在这项回顾性研究中，收集并分析了河北省 13 家定点医院收治的重症 COVID-19 患者的人口学、实验室和影像学以及治疗数据。结果：2020 年 1 月 22 日期间，13 家定点医院总共收治了 319 名重症 COVID-19 患者2020年3月25日，最终纳入51例重症患者（重症病例31例，危重症病例20例）。患者平均年龄为 58.9 +/- 13.7 岁，其中 27 名 (52.9%) 为男性。 21人（41.2%）有家族聚集性，33人（64.7%）有慢性病。重症组患者从出现症状到确诊的时间较长，感染更严重，肺损伤更严重，淋巴细胞百分比较低。 51例患者全部接受抗病毒药物治疗，其中47例（92.2%）患者接受抗菌药物治疗，49例（96.1%）患者接受中药治疗，46例（90.2%）患者接受甲泼尼龙治疗。重症患者接受更多液体和更多利尿治疗； 14 例（70.0%）需要有创机械通气，13 例（65.0%）出现肺外并发症。结论：有基础疾病且确认时间较长的 COVID-19 患者更有可能进展为重症 COVID-19。这些患者还存在较高的呼吸抑制、循环衰竭、肺外并发症和感染的风险。
Background: In December, 2019, a novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. We aimed to clarify the epidemiology, laboratory examinations, imaging findings, and treatment of critically ill patients with COVID-19 in Hebei province, China.Methods: In this retrospective study, the demographic, laboratory and imaging, and treatment data of patients with severe COVID-19 treated in 13 designated hospitals in Hebei were collected and analyzed.Results: A total of 319 severe COVID-19 patients were treated at the 13 designated hospitals between 22 January, 2020 and 25 March, 2020. Eventually, 51 critically ill (31 severe cases and 20 critically severe cases) patients were included in the analysis. The patients had an average age of 58.9 +/- 13.7 years, and 27 (52.9%) were men. Twenty-one (41.2%) were familial cluster, and 33 (64.7%) had chronic illnesses. The patients in critically severe group had longer duration from symptom to confirmation, more severe infections, more severe lung injury, and a lower percentage of lymphocytes. All 51 patients received antiviral drugs, 47 (92.2%) received antibacterial agents, 49 ( 96.1%) received traditional Chinese drugs, and 46 (90.2%) received methylprednisolone. The critically severe patients received more fluid and more diuretic treatment; 14 (70.0%) required invasive mechanical ventilation, and 13 (65.0%) developed extrapulmonary complications.Conclusions: COVID-19 patients who had underlying diseases and longer confirmation times were more likely to progress to critically severe COVID-19. These patients also presented with a higher risk of respiratory depression, circulatory collapse, extrapulmonary complications, and infection.