新型冠状病毒肺炎37例死亡原因分析

目的 分析和探讨新型冠状病毒肺炎（COVID-19）患者的死亡原因及其相关危险因素。方法选择住院期间死亡的37例COVID-19患者的主要临床资料进行回顾性分析。结果37例COVID-19死亡病例中男26例，女11例；年龄44～99岁，平均年龄(76.3±19.4)岁，65岁以上者30例（81.1%），有基础疾病者31例（83.8%），依次为高血压病、冠心病、糖尿病。86.5%患者有并发症，依次为血糖异常、继发感染、多器官功能衰竭（MODS)，多数患者有心、肝、肾、凝血功能异常。死亡原因主要是急性呼吸窘迫综合征（ARDS）、MODS、感染性休克。结论COVID-19患者中高龄、男性、基础疾病多、核酸检测阳性、持续高热者转归不佳，纠正低氧血症，控制基础疾病，稳定血压血糖，保护重要脏器功能，密切关注血钾、血小板和D-二聚体的变化，有利于改善预后、提高治疗效果。

The causes of death of 37 patients with coronavirus disease 2019

Objective To analyze the causes of death and associated risk factors in patients in coronavirus disease 2019 (COVID-19) patients. MethodsThe main clinical data and parameters of 37 COVID-19 patients who died during hospitalization were retrospectively selected and analyzed. ResultsThere were 26 male and 11 female deaths of COVID-19. The average age was (76.3±19.4) years (from 44 to 99). Among all deaths, 30 cases (81.1%) over 65 years; 31 cases (83.8%) with basic diseases, such as hypertension, coronary heart disease, diabetes in sequence; and 86.5% had complications, such as abnormal blood glucose, secondary infection, multiple organ dysfunction syndrome (MODS). Most patients had disfunction of heart, liver, kidney and coagulation. The main cause of death were followed by acute respiratory distress syndrome (ARDS), MODS, and septic shock. ConclusionsThe elderly, male COVID-19 patients with basic diseases, nucleic acid positive, persistent high fever were relatively serious. Correcting hypoxemia, controlling basic diseases, stabilizing blood pressure and glucose, protecting important organ function, and paying close attention to the changes of blood potassium, platelet and D- dimer could improve the prognosis and treatment effect.