Predictors of disease severity in patients hospitalized with coronavirus disease 2019.

IF 1.5 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Saudi Medicine Pub Date : 2023-07-01 Epub Date: 2023-08-03 DOI:10.5144/0256-4947.2023.254
Jameela Edathodu, Ali Alsugair, Muneerah Al-Bugami, Ibrahim Alomar, Abdulmajeed Alrasheed, Roqayah Fadel, Waad Albalawi, Amal Alshammary, Abdullah Alsuhaim, Saleh Alghayti, AlJawharah Alkadi, Mushtafa Peedikayil, Haifa Aldakhil, Norah Albedah, Gamal Mohamed
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引用次数: 0

Abstract

Background: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, manifests as a respiratory illness primarily and symptoms range from asymptomatic to severe respiratory syndrome and even death. During the pandemic, due to overcrowding of medical facilities, clinical assessment to triage patients for home care or in-hospital treatment was an essential element of management.

Objectives: Study the demographic features, comorbidities and bio-markers that predict severe illness and mortality from COVID-19 infection.

Design: Retrospective observational SETTING: Single tertiary care center PATIENTS AND METHODS: The study included all patients admitted with a positive PCR test for COVID-19 during the period from March 2020 to September 2020 (7 months). Data on demographics, clinical data and laboratory parameters was collected from medical records every 3 days during hospital stay or up until transfer to ICU.

Main outcome measures: Demographic, comorbidities and biochemical features that might predict severe COVID-19 disease.

Sample size: 372 RESULTS: Of the 372 patients, 72 (19.4%) had severe disease requiring admission to intensive care unit (ICU); 6 (1.6%) died. Individuals over 62 years were more likely to be admitted to the ICU (P=.0001, while a BMI of 40 and higher increased the odds of severe disease (P=.032). Male gender (P=.042), hypertension (P=.006) and diabetes (P=.001) conferred a statistically significant increased risk of admission to ICU, while coexisting COPD, and ischemic heart disease did not. Laboratory features related to severe COVID-19 infection were: leukocytosis (P=.015), thrombocytopenia (P=.001), high levels of C-reactive protein (P=.0001), lactic dehydrogenase (P=.0001), D-dimer (P=.0001) and ferritin (P=.001). With the multivariate analysis, diabetes, high lac-tate dehydrogenase, C-reactive protein and thrombocytopenia were associated with severity of illness.

Conclusions: Particular demographic and clinical parameters may predict severe illness and need for ICU care.

Limitations: Single referral center, several cases of severe COVID-19 could not be included due to lack of consent and or data.

Conflict of interest: None.

2019冠状病毒病住院患者疾病严重程度的预测因素。
背景:2019冠状病毒病(新冠肺炎)由新型冠状病毒引起,主要表现为呼吸道疾病,症状从无症状到严重呼吸道综合征,甚至死亡。在疫情期间,由于医疗设施过于拥挤,对患者进行临床评估以进行家庭护理或住院治疗是管理的一个重要组成部分。目的:研究预测新冠肺炎感染重症和死亡率的人口学特征、合并症和生物标志物。设计:回顾性观察环境:单一三级护理中心患者和方法:该研究包括2020年3月至2020年9月(7个月)期间新冠肺炎PCR检测呈阳性的所有患者。在住院期间或转入ICU之前,每3天从医疗记录中收集一次人口统计学、临床数据和实验室参数数据。主要结果指标:可能预测严重新冠肺炎疾病的人口统计学、合并症和生化特征。样本量:372结果:在372名患者中,72名(19.4%)患有严重疾病,需要入住重症监护室(ICU);死亡6例(1.6%)。62岁以上的人更有可能入住重症监护室(P=0.001,而BMI为40及以上会增加患严重疾病的几率(P=0.032)。男性(P=0.042)、高血压(P=0.006)和糖尿病(P=0.001)在统计学上显著增加了入住重症监护病房的风险,而COPD和缺血性心脏病共存则没有。与严重新冠肺炎感染相关的实验室特征为:白细胞增多症(P=.015)、血小板减少症(P=.001)、高水平C反应蛋白(P=.0001)、乳酸脱氢酶(P=.000 1)、D-二聚体(P=.0000 1)和铁蛋白(P=0.001)。通过多变量分析,糖尿病、高乳酸脱氢酶、C反应蛋白和血小板减少症与疾病严重程度相关。结论:特定的人口统计学和临床参数可以预测重症和ICU护理的需求。限制:单一转诊中心,由于缺乏同意书和/或数据,无法包括几例严重的新冠肺炎病例。利益冲突:无。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Saudi Medicine
Annals of Saudi Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
44
审稿时长
4-8 weeks
期刊介绍: The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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