印度阿萨姆邦南部三级医疗中心COVID-19患者的临床特征和死亡风险因素:一项回顾性研究

Riturag Thakuria, Nabaruna Paul, P. Baruah, P. Choudhury
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引用次数: 0

摘要

冠状病毒病-2019 (COVID-19)感染可引起广泛的症状,从无症状感染和轻度上呼吸道疾病到严重的病毒性肺炎并呼吸衰竭和多器官功能障碍。通过本研究,旨在了解COVID-19的临床特征、危险因素和实验室参数,这些参数可作为COVID-19严重疾病和阴性结局的预测因素。目的:研究印度东北部部分地区2019冠状病毒病(COVID-19)患者的临床特征、危险因素和实验室参数,并将这些参数在幸存者和非幸存者之间进行比较。材料和方法:本回顾性研究在印度阿萨姆邦西尔查尔的西尔查尔医学院和医院进行。研究对象为2020年7月1日至2020年12月31日住院的所有经逆转录聚合酶链反应(RTPCR)或快速抗原试验(RAT)诊断的COVID-19患者。资料包括人口学参数、症状、有意义的内科、外科或药物史等,实验室参数包括全血细胞计数、随机血糖(RBS)、胸片、肾功能和肝功能、c反应蛋白、乳酸脱氢酶(LDH)、血清铁蛋白、肌钙蛋白I等。对连续变量采用非配对t检验,比例比较采用卡方检验。结果:在2262例研究对象中,2066例(91.34%)康复出院,196例(8.66%)死亡。对死亡率有显著影响的各种参数是男性性别、年龄50至60岁、各种合并症,如糖尿病、高血压和心脏病。观察到与死亡率显著相关的实验室参数有血小板减少症、白细胞增多症、高血糖、乳酸脱氢酶、肌酐、d -二聚体、铁蛋白、c反应蛋白升高。放射学表现包括磨砂玻璃混浊和胸腔积液在非幸存者组中也比幸存者组更常见。结论:半数以上的死亡患者年龄在60岁以上。与康复者相比,非幸存者的合并症患病率和实验室参数的平均水平显着高。
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Clinical Characteristics and Risk Factors for Mortality in COVID-19 Patients at a Tertiary Care Centre in Southern Assam, India: A Retrospective Study
Introduction: Coronavirus Disease-2019 (COVID-19) infection can cause a wide range of symptoms, from asymptomatic infection and mild upper respiratory tract disease to severe viral pneumonia with respiratory failure and multiorgan malfunction. Through this study, effort was put forward to know the COVID-19 in terms of clinical characteristics, risk factors and laboratory parameters which in turn may serve as predictors of severe sickness and negative outcomes of COVID-19. Aim: To study the clinical characteristics, risk factors and laboratory parameters of COVID-19 patients in a part of North Eastern India, and also to compare these parameters between survivors and non survivors. Materials and Methods: This retrospective study was conducted in Silchar Medical College and Hospital, Silchar, Assam, India. Study included all patients of COVID-19 diagnosed by Reverse Transcriptase Polymerase Chain Reaction (RTPCR) or Rapid Antigen Test (RAT) admitted from 1st July, 2020 to 31st December, 2020. The data included demographic parameters, presenting symptoms, significant medical, surgical or drug history etc., and laboratory parameters including complete blood count, Random Blood Sugar (RBS), chest x-ray, renal and liver function test, C-reactive protein, Lactate Dehydrogenase (LDH), serum ferritin, troponin I etc. Data were statistically analysed by unpaired t-test for continuous variables and chi-square test was used for comparing proportions. Results: Out of a total 2262 study subjects, 2066 (91.34%) were discharged from the hospital after recovery and 196 (8.66%) had expired. The various parameters contributing significantly to mortality were male gender, age >60 years, various co-morbid conditions like diabetes mellitus, hypertension and cardiac illness. The laboratory parameters observed to be significantly associated with mortality were thrombocytopenia, leucocytosis, hyperglycaemia, raised value of lactate dehydrogenase, creatinine, D-dimer, ferritin, C-reactive protein. Radiological findings including ground glass opacities and pleural effusion also were more common in the non survivor group as compared to the survivor group. Conclusion: More than half of the deceased patients were older than 60 years of age. The prevalence of co-morbidities and mean level of laboratory parameters were significantly high among non survivors as compared to those who recovered.
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