意大利罗马第一波COVID-19大流行期间COVID-19患者的临床特征和死亡危险因素:一项单中心回顾性研究

Q2 Medicine
Emanuele Rando, Alessandra Oliva, Francesca Cancelli, Claudia D'Agostino, Giulia Savelloni, Maria Rosa Ciardi, Camilla Ajassa, Guido Siccardi, Gioacchino Galardo, Claudio M Mastroianni
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引用次数: 0

摘要

背景:自2020年初以来,SARS-CoV-2大流行已成为严重的公共卫生问题。大量研究强调了COVID-19的主要临床特征,主要是临床表现的巨大异质性,从无症状感染到死亡率高的严重病毒性肺炎都有可能。本研究的目的是回顾性分析意大利COVID-19患者队列的临床特征并评估死亡率的危险因素。方法:回顾性分析2020年3月至2020年5月在罗马“翁贝托1号”政治大学附属医院传染病病房收治的COVID-19患者。这些数据是意大利传染病和热带病学会(SIMIT)处理的基于网络的匿名电子数据库的一部分。结果:258例患者纳入分析,34例(13.2%)死亡。中位年龄62岁(IQR, 52-74岁),女性106例(40%),男性152例(60%),172例(66.7%)至少有一种合并症。最常见的体征和症状为:发热[221例(85.6%)]、咳嗽[135例(52.3%)]、呼吸困难[133例(51.5%)]。PaO2/FiO2比值经常发生改变[352 (IQR, 308-424)]。淋巴细胞减少[淋巴细胞计数,875/μL (IQR, 640-1250)]和高水平的d -二聚体[mg/dL, 874 (IQR, 484-1518)]。非幸存者比幸存者年龄大[中位年龄,74 (IQR, 67-85)],比61 (QR, 51-72)],大多数是男性[25(73.5%)],更常见的是有2个以上的合并症[21(61.8%)比94(42.1%)]。在多元logistic回归模型中,与住院死亡率相关的变量为年龄[OR, 3.65 (95% CI, 1.22-10.89)]、男性[OR, 2.99 (95% CI, 1.18-7.54)]、血尿素[OR, 2.76 (95% CI, 1.20-6.35)]和低PaO2/FiO2比值[OR, 0.28 (95% CI, 0.12-0.62)]。结论:新型冠状病毒病死率为13.2%。与院内死亡相关的危险因素为高龄、男性、血尿素升高和PaO2/FiO2比值降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics and risk factors for mortality in COVID-19 patients during the first wave of the COVID-19 pandemic in Rome, Italy: a single-center retrospective study.

Background: Since the beginning of 2020, the SARS-CoV-2 pandemic has become a serious public health problem. Numerous studies have highlighted the main clinical features of COVID-19, mainly the huge heterogeneity of the clinical manifestations that can vary from asymptomatic infection to serious viral pneumonia with a high mortality rate. The aim of this study was to analyze retrospectively the clinical characteristics and assess the risk factors for mortality in an Italian cohort of patients with COVID-19.

Methods: Retrospective analysis including patients with COVID-19 admitted to the Infectious Diseases wards of Azienda Ospedaliera Universitaria Policlinico "Umberto 1", Rome, from March 2020 to May 2020. The data were part of an electronic anonymous web-based database processed by SIMIT (Italian Society of Infectious and Tropical Diseases).

Results: 258 patients were included in the analysis, and 34 (13.2%) died. The median age was 62 (IQR, 52-74), 106 (40%) were women, and 152 (60%) were males, 172 (66.7%) had at least one co-morbidity. The most common signs and symptoms were: fever [221 (85.6%)], cough [135 (52.3%)], and dyspnea [133 (51.5%)]. The PaO2/FiO2 ratio was often altered [352 (IQR, 308-424)]. Lymphopenia [lymphocyte counts, 875/μL (IQR, 640-1250)] and high levels of D-dimer [mg/dL, 874 (IQR, 484-1518)] were found. Non-survivors were older than survivors [median age, 74 (IQR, 67-85)] vs. 61 (QR, 51-72)], mostly men [25 (73.5%)] and more frequently with more than 2 comorbidities [21 (61.8%) vs. 94 (42.1%)]. In the multiple logistic regression model, the variables associated with in-hospital mortality were age [OR, 3.65 (95% CI, 1.22-10.89)], male gender [OR, 2.99 (95% CI, 1.18-7.54)], blood urea [OR, 2.76 (95% CI, 1.20-6.35)] and a low PaO2/FiO2 ratio [OR, 0.28 (95% CI, 0.12-0.62)].

Conclusion: The mortality rate in COVID-19 was 13,2%. The risk factors associated with in-hospital mortality were advanced age, male sex, increased blood urea, and the PaO2/FiO2 ratio reduction.

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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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