重症新型冠状病毒肺炎发生的影响因素分析

Analysis on influencing factors of severe coronavirus disease 2019

摘要:

目的：分析重症新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）发生的影响因素，为COVID-19患者的个体化治疗提供依据。方法：回顾性分析火神山医院200例治愈出院的COVID-19患者病历资料，按照临床分型将其分为非重症（轻型/普通型）和重症（重型/危重型）2组，采用二分类logistic回归分析重症COVID-19的影响因素。结果：200例COVID-19患者中，非重症和重症患者人数占比分别为57.0%和43.0%；组间比较年龄（t=4.593，P＜0.001）、脉率（t=2.134，P=0.034）、高血压（χ2=23.933，P＜0.001）、糖尿病（χ2=5.141，P=0.023）、冠心病（χ2=5.879，P=0.015）、白蛋白（t=3.073，P=0.002）、白/球比值（t=2.127，P=0.035）和尿素氮（t=2.064，P=0.041）指标，差异具有统计学意义；二分类logistic回归分析发现，年龄（OR=1.040，95%CI=1.012~1.069，P=0.040）、脉率（OR=1.029，95%CI=1.000~1.006，P=0.051）和高血压病（OR=4.378，95%CI=2.033~9.429，P＜0.001）是重症COVID-19发生的独立危险因素。结论：对高龄、伴有基础疾病尤其是高血压病的COVID-19患者，应当及时进行针对性干预，降低COVID-19重症发生的潜在风险。

Abstract:

Objective：To analyze the severe coronavirus disease 2019（COVID-19） influencing factors and provide evidence for indi－vidualized treatment of COVID-19 patients. Methods：The med－ical records of 200 cured and discharged COVID-19 patients in Vulcan Mountain Hospital were retrospectively analyzed，and they were divided into two groups according to clinical classi－fications：non-severe（light/normal） and severe（severe/critical）. Binary logistic regression was used to estimate potential risk factors for severe COVID-19. Results：The proportion of the 200 COVID-19 patients with non-severe and severe diseases was 57.0% and 43.0%，respectively. There were significant differences in age（t=4.593，P＜0.001），pulse rate（t=2.134，P=0.034），hypertension（χ2=23.933，P＜0.001），diabetes（χ2=5.141，P=0.023），coronary heart dis－ease（χ2=5.879，P=0.015），albumin（t=3.073，P=0.002），ratio of albumin to globulin（t=2.127，P=0.035），and urea nitrogen（t=2.064，P=0.041）. Binary logistic regression analysis showed that age（OR=1.040，95%CI=1.012-1.069，P=0.040），pulse rate（OR=1.029，95%CI=1.000-1.006，P=0.051） and hypertension（OR=4.378，95%CI=2.033-9.429，P＜0.001） were independent risk factors of severe COVID-19. Conclusion：We should give timely targeted intervention to the elderly patients with basic diseases，especially hypertension，so as to reduce the potential risk of severe COVID-19.