COVID - 19合并胸膜和心包积液10例临床特点

Y. Guo, L. Zhang, R. Li, S. Tian, W. Dong
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摘要

目的:回顾性分析2019冠状病毒病(COVID - 19)合并胸膜和心包积液患者的临床特点。方法:回顾性分析武汉大学人民医院2020年1月20日至2020年3月23日收治的60例新冠肺炎住院患者的资料,其中合并胸腔积液(PLE)和心包积液(PCE)的患者10例,未合并胸腔积液/心包积液的患者50例。记录和分析患者的病史、临床特征、体格检查、实验室检查结果和胸部断层成像。统计显著性采用卡方检验、Fisher精确检验和Mann - Whitney U检验确定。结果:合并PLE和PCE的COVID - 19患者比未合并PLE和PCE的患者体温升高(P<0.001),呼吸急促发生率(P=0.024)和呼吸频率加快(P=0.004),实验室结果显示,合并PLE和PCE的患者C反应蛋白(CRP,P=0.039)和D -二聚体(P=0.038)水平较高,淋巴细胞(P=0.024)、血红蛋白(P=0.003)、CD4+T细胞计数(P=0.016)和血氧饱和度(P=0.037)水平较低。合并PLE、PCE患者的重症、危重症发生率及病死率均高于未合并PLE、PCE患者(P<0.05)。结论:PLE和PCE是严重炎症和不良临床结局的指标,可能是COVID - 19危重型患者的独立危险因素。提示对新冠肺炎合并PLE和PCE患者的治疗应更加积极和及时。©2021,武汉大学医学杂志编辑委员会。版权所有。
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Clinical characteristics of COVID‑19 complicated with pleural and pericardial effusion in 10 patients
Objective: To retrospectively analyze the clinical characteristics of corona virus disease 2019 (COVID‑19) patients with pleural and pericardial effusion. Methods: We retrospectively reviewed and compared data of 60 COVID‑19 inpatients including 10 patients with pleural effusion (PLE) and pericardial effusion (PCE) and 50 cases without PLE/PCE, from January 20, 2020 to March 23, 2020 in Renmin Hospital of Wuhan University. The patients' medical history, clinical features, physical findings, laboratory test results, and chest tomographic imaging were recorded and analyzed. Statistical significance was determined using the chi‑square test, Fisher's exact test, and the Mann‑Whitney U‑test. Results: COVID‑19 patients with PLE and PCE had a higher temperature (P<0.001), a higher incidence of breath shortness (P=0.024) and faster respiratory frequency (P=0.004) than those without PLE and PCE. Laboratory findings showed that patients with PLE and PCE had higher levels of C‑reactive protein (CRP,P=0.039) and D‑dimer (P=0.038), and lower levels of lymphocytes (P=0.024), hemoglobin (P=0.003), CD4+T cell counts (P=0.016), and oxygen saturation (P=0.037). Meanwhile, patients with PLE and PCE had higher incidence of severe or critical illness and mortality rates as compared with those without PLE and PCE (all P<0.05). Conclusion: PLE and PCE were indicators for severe inflammation and poor clinical outcomes, and might be independent risk factors for critical type in COVID‑19 patients. It suggests that the treatment for the COVID‑19 patients with PLE and PCE should be more active and timely. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
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来源期刊
武汉大学学报(医学版)
武汉大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.30
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0.00%
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7289
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