COVID-19 患者住院死亡率的特征和预测因素的性别差异。

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Respiration Pub Date : 2024-01-01 Epub Date: 2024-05-22 DOI:10.1159/000539281

Shirui Meng, Zechun Zeng, Huijuan Zuo, Jinwen Wang

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引用次数: 0

摘要

导言：自2022年10月起，随着冠状病毒病（COVID-19）在北京的流行，住院人数明显增加。本研究旨在评估与 COVID-19 患者院内死亡率相关的因素：方法：利用住院患者的数据，评估确诊为 COVID-19 的患者在临床特征、院内管理和院内死亡率方面的性别差异。此外，还对北京安贞医院（中国北京）在2022年10月至2023年1月期间收治的1091名COVID-19患者的死亡率相关预测因素进行了评估：分析纳入了1091名COVID-19住院患者的数据。男性和女性的院内死亡率分别为14.9%和10.4%。多因素逻辑分析显示，淋巴细胞百分比（LYM%）（几率比[OR] 0.863 [95% 置信区间（CI）0.805-0.925]；P<0.001）、尿酸（OR 1.004 [95% CI 1.002-1.006]；P=0.001）和高敏C反应蛋白（hs-CRP）（OR 1.094 [95% CI 1.012-1.183]；P=0.024）与COVID-19的院内死亡率独立相关。在女性患者中，多因素分析显示，LYM%（OR 0.856 [95% CI 0.796-0.920]；P<0.001）、年龄较大（OR 1.061 [95% CI 1.020-1.103]；P=0.003）、肥胖（OR 2.590[95%CI1.131-5.931]；P=0.024）、高敏肌钙蛋白 I 水平高（OR 2.602[95%CI 1.157-5.853]；P=0.021）是院内死亡的危险因素。接收者操作特征（ROC）曲线分析显示，LYM%在预测男性院内死亡方面的有效性及其ROC曲线下面积（AUC）为0.800，敏感性为63.2%，特异性为83.2%。预测女性住院死亡的 AUC 为 0.815，灵敏度为 87.5%，特异度为 64.4%：结论：LYM%是预测男女住院死亡率的一致指标。结论：LYM%是男女患者院内死亡率的一致预测指标，年龄越大，全身炎症、心肌损伤和代谢失调的标记物越多，死亡率越高。这些发现有助于确定哪些患者需要更密切的监测和有针对性的干预，以改善预后。

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Sex Difference in Characteristics and Predictors of In-Hospital Mortality among Patients with COVID-19.

Introduction: With a surge in the prevalence of coronavirus disease-2019 (COVID-19) in Beijing starting in October 2022, hospitalisation rates increased markedly. This study aimed to evaluate factors associated with in-hospital mortality in patients with COVID-19.

Methods: Using data from hospitalised patients, sex-based differences in clinical characteristics, in-hospital management, and in-hospital mortality among patients diagnosed with COVID-19 were evaluated. Predictive factors associated with mortality in 1,091 patients admitted to the Beijing Anzhen Hospital (Beijing, China) for COVID-19 between October 2022 and January 2023 were also evaluated.

Results: Data from 1,091 patients hospitalised with COVID-19 were included in the analysis. In-hospital mortality rates for male and female patients were 14.9% and 10.4%, respectively. Multifactorial logistic analysis indicated that lymphocyte percentage (LYM%) (odds ratio [OR] 0.863, 95% confidence interval [CI] 0.805-0.925; p < 0.001), uric acid (OR 1.004, 95% CI: 1.002-1.006; p = 0.001), and high-sensitivity C-reactive protein (OR 1.094, 95% CI: 1.012-1.183; p = 0.024) levels were independently associated with COVID-19-related in-hospital mortality. Among female patients, multifactorial analysis revealed that LYM% (OR 0.856, 95% CI: 0.796-0.920; p < 0.001), older age (OR 1.061, 95% CI: 1.020-1.103; p = 0.003), obesity (OR 2.590, 95% CI: 1.131-5.931; p = 0.024), and a high high-sensitivity troponin I level (OR 2.602, 95% CI: 1.157-5.853; p = 0.021) were risk factors for in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, including area under the ROC curve, showed that the efficacy of LYM% in predicting in-hospital death was 0.800 (sensitivity, 63.2%; specificity, 83.2%) in male patients and 0.815 (sensitivity, 87.5%; specificity, 64.4%) in female patients.

Conclusion: LYM% is a consistent predictor of in-hospital mortality for both sexes. Older age and markers of systemic inflammation, myocardial injury, and metabolic dysregulation are also associated with a high mortality risk. These findings may help identify patients who require closer monitoring and tailored interventions to improve outcomes.

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来源期刊

Respiration 医学-呼吸系统

CiteScore

7.30

自引率

5.40%

发文量

审稿时长

4-8 weeks

期刊介绍： ''Respiration'' brings together the results of both clinical and experimental investigations on all aspects of the respiratory system in health and disease. Clinical improvements in the diagnosis and treatment of chest and lung diseases are covered, as are the latest findings in physiology, biochemistry, pathology, immunology and pharmacology. The journal includes classic features such as editorials that accompany original articles in clinical and basic science research, reviews and letters to the editor. Further sections are: Technical Notes, The Eye Catcher, What’s Your Diagnosis?, The Opinion Corner, New Drugs in Respiratory Medicine, New Insights from Clinical Practice and Guidelines. ''Respiration'' is the official journal of the Swiss Society for Pneumology (SGP) and also home to the European Association for Bronchology and Interventional Pulmonology (EABIP), which occupies a dedicated section on Interventional Pulmonology in the journal. This modern mix of different features and a stringent peer-review process by a dedicated editorial board make ''Respiration'' a complete guide to progress in thoracic medicine.