■新型冠状病毒病(COVID-19)已在全球蔓延,并造成300多万人死亡,对公共卫生和医疗系统构成巨大挑战。有限的数据是疾病进展的可用预测因素。我们旨在评估重症和危重症COVID-19患者肺部加重的临床和放射学预测因素。
■武汉大学人民医院确诊的COVID-19患者,中国,2月之间6th,2020年2月21日,2020年是回顾性收集的。根据初始和随访的胸部CT将纳入的患者分为非进展组和进展组。临床,实验室,和放射学变量进行了分析。
■在研究期间,确定了162名患者,总共126名患者,最终分析包括97例(77.0%)重症病例和29例(23.0%)重症病例。年龄中位数为66.0(IQR,56.0-71.3)年。从发病到初次胸部CT的中位时间为15.0(IQR,12.0-20.0)天,中位随访间隔为7.0(IQR,5.0-7.0)天。与那些没有进步的人相比(n=111,88.1%),进展组患者(n=15,11.9%)的峰值体温>38°C的百分比显着升高(P=0.002),血小板计数降低(P=0.011),较低的CD4T细胞计数(P=0.002),CD8计数降低(P=0.011),较高的肌酸激酶水平(P=0.002),肾小球滤过率降低(P=0.018)。在单变量和多变量分析中,只有CD4T细胞计数<200/μL是显著的(OR,6.804;95%CI,1.450-31.934;P=0.015)用于预测肺进展。
■低CD4T细胞计数可预测COVID-19重症和危重患者肺部病变的进展。
UNASSIGNED: Novel coronavirus disease (COVID-19) has spread globally and caused over 3 million deaths, posing great challenge on public health and medical systems. Limited data are available predictive factors for disease progression. We aim to assess clinical and radiological predictors for pulmonary aggravation in severe and critically ill COVID-19 patients.
UNASSIGNED: Patients with confirmed COVID-19 in Renmin Hospital of Wuhan University, China, between Feb. 6th, 2020 and Feb. 21st, 2020 were retrospectively collected. Enrolled patients were divided into non-progression group and progression group based on initial and follow-up chest CTs. Clinical, laboratory, and radiological variables were analyzed.
UNASSIGNED: During the study period, 162 patients were identified and a total of 126 patients, including 97 (77.0%) severe cases and 29 (23.0%) critically ill cases were included in the final analysis. Median age was 66.0 (IQR, 56.0-71.3) years. Median time from onset to initial chest CT was 15.0 (IQR, 12.0-20.0) days and median interval to follow-up was 7.0 (IQR, 5.0-7.0) days. Compared with those who did not progress (n=111, 88.1%), patients in the progression group (n=15, 11.9%) had significantly higher percentage of peak body temperature >38 °C (P=0.002), lower platelet count (P=0.011), lower CD4 T cell count (P=0.002), lower CD8 count (P=0.011), higher creatine kinase level (P=0.002), and lower glomerular filtration rate (P=0.018). On both univariate and multivariable analysis, only CD4 T cell count <200/µL was significant (OR, 6.804; 95% CI, 1.450-31.934; P=0.015) for predicting pulmonary progression.
UNASSIGNED: Low CD4 T cell count predicts progression of pulmonary change in severe and critically ill patients with COVID-19.