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常见社区人类冠状病毒疾病的流行病学及临床特征

Epidemiology and clinical features of common community human coronavirus disease.

作者信息

Kim Taehee, Choi Hayoung, Shin Tae Rim, Ko Yousang, Park Yong Bum, Kim Hwan Il, Jang Seung Hun, Jung Ki Suck, Kim Youlim, Lee Myung Goo, Chung Soojie, Kim Cheol-Hong, Hyun In Gyu, Sim Yun Su

机构信息

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.

Lung Research Institute, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Republic of Korea.

出版信息

J Thorac Dis. 2021 Apr;13(4):2288-2299. doi: 10.21037/jtd-20-3190.

Abstract

BACKGROUND

We would evaluate the epidemiology, clinical aspects, and prognostic factors of patients of all ages admitted with human corona virus (HCoV).

METHODS

This study was retrospectively performed at five university teaching hospitals between 1st January 2018 and 31th March 2020. Routine molecular testing using for multiplex real-time reverse transcription-polymerase chain reaction (RT-PCR) methods was conducted on the respiratory viruses. We assessed the demographics, laboratory findings, and treatment of patients infected with coronavirus.

RESULTS

There were 807 coronavirus-infected patients from 24,311 patients with respiratory virus PCR test admitted to five hospitals over 27 months. All-cause mortality rates of patients admitted for seasonal HCoV disease were 3.1% in all patients and 10.8% in patients aged ≥18 years. The Cox proportional hazard regression analysis was performed in patients aged ≥18 years. After adjusting for other clinical variables, general weakness symptoms [hazard ratio (HR), 2.651; 95% confidence interval (CI), 1.147-6.125, P=0.023], National Early Warning Score (NEWS) ≥2 (HR, 5.485; 95% CI, 1.261-23.858, P=0.023), and coronavirus subtype OC43 (HR, 2.500; 95% CI, 1.060-5.897, P=0.036) were significantly associated with death from coronavirus.

CONCLUSIONS

Coronavirus infection can reveal a higher mortality rate in patients of ≥18 than those of <18 years, thus, adult patients require more careful treatment. Furthermore, in adult patients, the factors associated with death from coronavirus include general weakness symptoms, NEWS higher than 2, and OC43 subtype.

摘要

背景

我们将评估所有年龄段感染人类冠状病毒(HCoV)患者的流行病学、临床特征及预后因素。

方法

本研究于2018年1月1日至2020年3月31日在五所大学教学医院进行回顾性研究。采用多重实时逆转录聚合酶链反应(RT-PCR)方法对呼吸道病毒进行常规分子检测。我们评估了冠状病毒感染患者的人口统计学特征、实验室检查结果及治疗情况。

结果

在27个月内,五所医院收治的24311例进行呼吸道病毒PCR检测的患者中,有807例冠状病毒感染患者。季节性HCoV疾病患者的全因死亡率在所有患者中为3.1%,在≥18岁患者中为10.8%。对≥18岁患者进行Cox比例风险回归分析。在调整其他临床变量后,全身乏力症状[风险比(HR),2.651;95%置信区间(CI),1.147 - 6.125,P = 0.023]、国家早期预警评分(NEWS)≥2(HR,5.485;95% CI,1.261 - 23.858,P = 0.023)以及冠状病毒OC43亚型(HR,2.500;95% CI,1.060 - 5.897,P = 0.036)与冠状病毒死亡显著相关。

结论

冠状病毒感染在≥18岁患者中的死亡率高于<18岁患者,因此,成年患者需要更精心的治疗。此外,在成年患者中,与冠状病毒死亡相关的因素包括全身乏力症状、NEWS高于2以及OC43亚型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88d/8107519/94a3d61528f6/jtd-13-04-2288-f1.jpg

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