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                英国团队剖析了20133名covid-19住院患者的临床特性

                2020-05-29 19:42泉源:迷信网
                导读:总之,covid-19住院患者殒命率很高,其独立风险要素是年事、男性和包罗瘦削在内的慢性兼并症。

                英国利物浦大学Malcolm G Semple团队剖析了20133名英国covid-19住院患者的临床特性。2020年5月22日,《英国医学杂志》宣布了这一效果。

                为了剖析英国在疫情第一波迸发的增长阶段,covid-19住院患者的临床特性,并讨论与医院殒命相干的风险要素,研讨组停止了一项疾速数据搜集和近及时剖析的前瞻性察看性行列步队研讨。

                2020年2月6日至4月19日,研讨组在英格兰、威尔士和苏格兰设立了208家急诊医院,共招募了20133名covid-19住院患者,中位年事为73岁。男性占60%,多于女性(40%)。出院前症状的中位继续工夫为4天。最罕见的兼并症是慢性心脏病(31%)、单纯性糖尿病(21%)、非哮喘性慢性肺病(18%)和慢性肾脏病(16%),23%的患者未陈诉严峻兼并症。

                停止到陈诉日期,41%的患者在世出院,26%殒命,34%持续承受医治。17%的患者需进入高度依赖或重症监护病房,此中28%在世出院,32%殒命,41%持续承受医治。承受机器通气的患者中,有17%在世出院,37%殒命,46%仍在住院。年事增长、男性以及包罗慢性心脏病、非哮喘性慢性肺病、慢性肾脏病、肝病和瘦削症等兼并症均与更高的院内殒命率有关。

                总之,covid-19住院患者殒命率很高,其独立风险要素是年事、男性和包罗瘦削在内的慢性兼并症。

                附:英文原文

                Title: Features of 20133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study

                Author: Annemarie B Docherty, Ewen M Harrison, Christopher A Green, Hayley E Hardwick, Riinu Pius, Lisa Norman, Karl A Holden, Jonathan M Read, Frank Dondelinger, Gail Carson, Laura Merson, James Lee, Daniel Plotkin, Louise Sigfrid, Sophie Halpin, Clare Jackson, Carrol Gamble, Peter W Horby, Jonathan S Nguyen-Van-Tam, Antonia Ho, Clark D Russell, Jake Dunning, Peter JM Openshaw, J Kenneth Baillie, Malcolm G Semple

                Issue&Volume: 2020/05/22

                Abstract: Objective To characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and to explore risk factors associated with mortality in hospital.

                Design Prospective observational cohort study with rapid data gathering and near real time analysis.

                Setting 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. A case report form developed by ISARIC and WHO was used to collect clinical data. A minimal follow-up time of two weeks (to 3 May 2020) allowed most patients to complete their hospital admission.

                Participants 20133 hospital inpatients with covid-19.

                Main outcome measures Admission to critical care (high dependency unit or intensive care unit) and mortality in hospital.

                Results The median age of patients admitted to hospital with covid-19, or with a diagnosis of covid-19 made in hospital, was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%, n=12068; women 40%, n=8065). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities were chronic cardiac disease (31%, 5469/17702), uncomplicated diabetes (21%, 3650/17599), non-asthmatic chronic pulmonary disease (18%, 3128/17634), and chronic kidney disease (16%, 2830/17506); 23% (4161/18525) had no reported major comorbidity. Overall, 41% (8199/20133) of patients were discharged alive, 26% (5165/20133) died, and 34% (6769/20133) continued to receive care at the reporting date. 17% (3001/18183) required admission to high dependency or intensive care units; of these, 28% (826/3001) were discharged alive, 32% (958/3001) died, and 41% (1217/3001) continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% (618/1658) died, and 46% (764/1658) remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.

                Conclusions ISARIC WHO CCP-UK is a large prospective cohort study of patients in hospital with covid-19. The study continues to enrol at the time of this report. In study participants, mortality was high, independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity. This study has shown the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.

                DOI: 10.1136/bmj.m1985

                Source: http://www.bmj.com/content/369/bmj.m1985 

                期刊信息

                BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。从属于BMJ出书团体,最新IF:27.604
                官方网址:http://www.bmj.com/
                投稿链接:http://mc.manuscriptcentral.com/bmj

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