研究：與紐約市4013位COVID-19病人入院和危重症相關的因素--- 65歲以上的胖子要注意

Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City

Christopher M. Petrilli,  View ORCID ProfileSimon A. Jones, Jie Yang, Harish Rajagopalan, Luke F. O'Donnell, Yelena Chernyak, Katie Tobin, Robert J. Cerfolio, Fritz Francois,  View ORCID ProfileLeora I. Horwitz

doi: https://doi.org/10.1101/2020.04.08.20057794

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

 

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Google translate:

背景：

Covid-19陽性患者的住院和危重病相關因素知之甚少。

 

方法：

我們對2020年3月1日至2020年4月2日期間在紐約市單一學術衛生係統治療的所有實驗室確診Covid-19患者進行了橫斷麵分析，並隨訪至2020年4月7日。主要結果是住院和重症疾病（重症監護，機械通氣，臨終關懷和/或死亡）。我們進行了多變量logistic回歸以識別不良後果的風險因素，並進行了最大程度的信息獲取決策樹分類以識別關鍵因素。

 

結果：

在4,103名Covid-19患者中，有1,999名（48.7％）入院，其中981 / 1,999名（49.1％）已出院回家，而292 / 1,999名（14.6％）已死亡或出院了。在445名需要機械通氣的患者中，有162/445名（36.4％）死亡。

 

住院風險最高的是:

 

年齡≥75歲（OR 66.8，95％CI，44.7-102.6），65-74歲（OR 10.9，95％CI，8.35-14.34），

BMI  > 40（OR 6.2，95％CI，4.2 -9.3）和

心力衰竭（OR 4.3 95％CI，1.9-11.2）。

 

最嚴重疾病風險是:

 

入院血氧飽和度<88％（OR 6.99，95％CI 4.5-11.0)

d-二聚體> 2500（OR 6.9，95％CI，3.2-15.2）

鐵蛋白> 2500（OR 6.9，95％ CI，3.2-15.2)

C反應蛋白（CRP）> 200（OR 5.78，95％CI，2.6-13.8）

 

在入院決策樹中，最重要的特征是65歲以上和肥胖。對於重症疾病，最重要的是SpO2 <88，其次是降鈣素原> 0.5，肌鈣蛋白<0.1（保護性），年齡> 64和CRP> 200。

 

結論：

 

年齡和合並症是住院的有力預測因素。然而，入院氧損傷和炎症標誌物與重症疾病最密切相關。

Abstract

Background: Little is known about factors associated with hospitalization and critical illness in Covid-19 positive patients. Methods: We conducted a cross-sectional analysis of all patients with laboratory-confirmed Covid-19 treated at a single academic health system in New York City between March 1, 2020 and April 2, 2020, with follow up through April 7, 2020. Primary outcomes were hospitalization and critical illness (intensive care, mechanical ventilation, hospice and/or death). We conducted multivariable logistic regression to identify risk factors for adverse outcomes, and maximum information gain decision tree classifications to identify key splitters. Results: Among 4,103 Covid-19 patients, 1,999 (48.7%) were hospitalized, of whom 981/1,999 (49.1%) have been discharged home, and 292/1,999 (14.6%) have died or were discharged to hospice. Of 445 patients requiring mechanical ventilation, 162/445 (36.4%) have died. Strongest hospitalization risks were age ≥75 years (OR 66.8, 95% CI, 44.7-102.6), age 65-74 (OR 10.9, 95% CI, 8.35-14.34), BMI>40 (OR 6.2, 95% CI, 4.2-9.3), and heart failure (OR 4.3 95% CI, 1.9-11.2). Strongest critical illness risks were admission oxygen saturation <88% (OR 6.99, 95% CI 4.5-11.0), d-dimer>2500 (OR 6.9, 95% CI, 3.2-15.2), ferritin >2500 (OR 6.9, 95% CI, 3.2-15.2), and C-reactive protein (CRP) >200 (OR 5.78, 95% CI, 2.6-13.8). In the decision tree for admission, the most important features were age >65 and obesity; for critical illness, the most important was SpO2<88, followed by procalcitonin >0.5, troponin <0.1 (protective), age >64 and CRP>200. Conclusions: Age and comorbidities are powerful predictors of hospitalization; however, admission oxygen impairment and markers of inflammation are most strongly associated with critical illness.

所有跟帖： 

• 胖子肉多，血管緊張素超多？ -nowayitsover- ♂ (0 bytes) () 04/14/2020 postreply 09:52:35