重型危重型新型冠状病毒肺炎危险因素分析

目的 分析重型危重型新型冠状病毒肺炎(简称新冠肺炎)发生的危险因素,为早期预测新冠肺炎轻型普通型进展为重型危重型提供依据。 方法 收集2020年1月17日—3月14日在长沙市第一医院收治的新冠肺炎确诊患者的基本情况、流行病学、临床和实验室资料。采用回顾性队列分析研究重型危重型新冠肺炎发生的危险因素,单因素χ²检验和多因素logistic回归分析相关指标。 结果 169例患者纳入研究,其中136例为轻型普通型,33例为重型危重型。单因素分析显示,重型危重型和轻型普通型在年龄、饮酒史、感染地为湖北、有明确接触史、合并慢性心脏病、高血压、总蛋白、白蛋白、淋巴细胞、血糖、乳酸脱氢酶、降钙素原、C反应蛋白差异有统计学意义(P＜0.05);多因素logistic分析显示,有饮酒史(OR=3.06)、有慢性心脏疾病(OR=15.26)、总蛋白偏低(OR=2.13)、入院时血糖升高(OR=4.91)、C反应蛋白升高(OR=12.34)为重型危重型新冠肺炎的独立危险因素(P＜0.05)。 结论 有饮酒史、有慢性心脏疾病、入院时总蛋白偏低、血糖升高、C反应蛋白升高为重型危重型新冠肺炎的危险因素。提示医师在诊疗过程中应重点关注有以上因素的轻型普通型新冠肺炎患者。

Risk factors for severe and critical COVID-19

Objective To analyze the risk factors of occurring severe and critical coronavirus disease 2019 (COVID-19), and to provide a basis for early predicting the progress from light and common COVID-19 to severe and critical conditions. Methods We collected the data about general, epidemiological, clinical and laboratory information of COVID-19 confirmed cases hospitalized in the First Hospital of Changsha City from January 17 to March 14 in 2020. Retrospective cohort analysis was applied to analyzing the risk factors of occurring severe and critical COVID-19. Single-factor Chi-square test and multivariate logistic regression were used to analyze the relevant indicators. Results One hundred and sixty-nine patients were included in this study, including 136 light and common cases and 33 severe and critical cases. Single factor analysis showed that there were statistically significant differences in age, having a history of alcohol consumption, having the infection in Hubei Province, having an explicit contact history, complicating with chronic heart disease, hypertension, total protein (TP), albumin, lymphocyte, blood glucose, lactate dehydrogenase, procalcitonin (PCT) and C-reactive protein (CRP) between light and common cases and severe and critical cases (all P<0.05). Multivariate logistic regression analysis indicated that having a history of alcohol consumption (OR=3.06), having chronic heart disease (OR=15.26), low TP level(OR=2.13), elevated blood glucose level on admission (OR=4.91) and elevated CRP level(OR=12.34)were independent risk factors for severe and critical COVID-19 (P<0.05). Conclusions Having a history of alcohol consumption, having chronic heart disease, low TP, high blood glucose and high CRP levels on admission are risk factor for severe and critical COVID-19. The results suggest that physicians should payspecial attention to light and common patients with COVID-19 having the above-mentioned factors.