新型冠状病毒肺炎死亡病例临床特征分析

摘要：目的 回顾性分析新型冠状病毒肺炎（新冠肺炎）死亡患者的临床特点,为指导临床治疗和评估预后提供经验。方法 对我院收治的73例新冠肺炎死亡患者的资料进行回顾性分析,包括一般资料、基础性疾病、并发症、实验室检查指标、影像学资料以及治疗方法等,并分析与死亡有关的临床特点。结果 73例新冠肺炎死亡患者中发热常为首发症状,≥60岁者52例（71.2%）;有基础疾病者47例（64.4%）,糖尿病居首位,其次是高血压和其他心血管疾病;急性呼吸窘迫综合征是死亡患者的主要并发症,出现54例（74.0%）。实验室检查结果显示患者淋巴细胞和动脉氧分压持续下降,D-二聚体、C-反应蛋白、天冬氨酸转氨酶、尿素氮、肌酐等升高,新型冠状病毒对全身多个脏器均有损害。胸部CT呈多叶、多灶且迅速进展的肺部磨玻璃样改变是死亡患者的主要影像学特点。顽固性低氧血症患者机械通气效果不佳。结论 新冠肺炎死亡患者的流行病学、临床症状、实验室检查和肺部影像学特点有其特征性表现,充分认识其特点,有利于早期干预和改善预后

Clinical feature analysis on death cases of the COVID-19

Abstract: Objective To analyze clinical characteristics in patients died of coronavirus disease 2019 (COVID-19),and provide experience for guiding clinical treatment and evaluating prognosis. Methods Data of 73 dead cases of theCOVID-19 admitted to our hospital from January to March 2020 were retrospectively analyzed. The clinical data includedgeneral data, underlying disease, complication, biochemical laboratory examination, imaging examination and therapeuticmethods. The clinical characteristics related to death were analyzed. Results In 73 COVID-19 patients, fever was often thefirst symptom. Fifty-two cases (71.2%) were over 60 years old. Forty-seven cases (64.4%) had underlying diseases,in whichdiabetes ranked first, followed by hypertension and other cardiovascular diseases. Acute respiratory distress syndrome(ARDS) was the main complication of the dead, which occurred in 54 cases (74.0%). Biochemical laboratory tests showedthat continuing decline of the lymphocytes and p(O2), the increase of the D-Dimer, C-reactive protein, aspartatetransaminase, urea nitrogen and creatinne, which indicated that the COVID-19 can cause multiple organ dysfunction. Themain imaging features of the dead cases were the ground glass changes of the lungs with multi-lobes or multifocal changeand rapid progress. For patients with refractory hypoxemia, the mechanical ventilation was not effective. Conclusion Thedeath cases of the COVID-19 are characterized by epidemiology, clinical manifestation, laboratory examination andpulmonary imaging. Fully recognizing its characteristics is conducive to the early intervention and improvement of prognosis.