[1]向和东,刘川,柯景彬,等.基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系[J].第三军医大学学报,2021,43(08):722-729.
 XIANG Hedong,LIU Chuan,KE Jingbin,et al.Correlation of hypocalcemia with poor prognosis of COVID-19 based on COX regression model: an analysis of 2 651 patients[J].J Third Mil Med Univ,2021,43(08):722-729.
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基于COX回归模型分析2 651例COVID-19患者低血钙与不良预后的关系(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
43卷
期数:
2021年第08期
页码:
722-729
栏目:
临床医学
出版日期:
2021-04-30

文章信息/Info

Title:
Correlation of hypocalcemia with poor prognosis of COVID-19 based on COX regression model: an analysis of 2 651 patients
作者:
向和东刘川柯景彬谭虎张丽敏丁小涵李平高旭滨杨杰黄岚
陆军军医大学(第三军医大学)第二附属医院心血管内科,全军心血管病研究所
Author(s):
XIANG Hedong LIU Chuan KE Jingbin TAN Hu ZHANG Limin DING Xiaohan LI Ping GAO Xubin YANG Jie HUANG Lan
Department of Cardiovascular Diseases, Institute of Cardiovascular Diseases of PLA, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
 
关键词:
低血钙COVID-19预后COX回归回顾性研究
Keywords:
hypocalcemia COVID-19 prognosis COX regression retrospective study
分类号:
R511; R563.107; R591.1
文献标志码:
A
摘要:

目的探讨低血钙与COVID-19患者预后不良的关系。方法回顾性分析2020年2月4日至4月11日在武汉火神山医院就诊的2 651例COVID-19患者资料,对比分析低血钙组患者(n=773)与正常血钙组患者(n=1 878)的人口学基本特征、实验室检查、治疗、并发症和预后结果,采用Cox回归模型分析低血钙是否为COVID-19患者预后不良的独立危险因素。结果与正常血钙组比较,低血钙组患者机械通气使用率、体外膜肺氧合使用率和重症监护室入住率显著升高(P<0.05),脓毒血症、休克、急性呼吸窘迫综合征、呼吸衰竭、低蛋白血症、急性心肌损伤、急性肾脏损伤、凝血障碍发生率和死亡率也显著增加(P<0.05),住院时间显著延长(P<0.001);轻型及普通型、重型、危重型COVID-19患者中血钙水平分别为2.17 (2.11,2.24)、2.13 (2.04,2.21)、2.03 (1.89,2.18) mmol/L,不同类型间患者血钙差异有统计学意义(P<0.05),并且随着COVID-19的临床类型加重血钙值越低(P<0.05),死亡患者血钙值显著低于非死亡患者[1.97 (1.87, 2.03) vs 2.17 (2.09, 2.23) mmol/L,P<0.001];多元Cox回归模型分析显示,血钙<2.11 mmol/L是COVID-19患者预后不良的独立危险因素(HR=5.695,95%CI:2.363~13.725,P<0.001)。结论低血钙是影响COVID-19患者预后不良的独立危险因素,纠正低血钙可能是改善COVID-19患者预后的重要策略。

Abstract:

ObjectiveTo investigate whether hypocalcemia is associated with poor prognosis in COVID-19 patients. MethodsA retrospective analysis was performed on 2 651 COVID-19 patients admitted to Wuhan Huoshenshan Hospital from February 4, 2020 to April 11, 2020. They were divided into low and normal calcium groups according to their serum calcium level lower than 2.11 mmol/L or not. Their basic demographic characteristics, results of laboratory tests, treatment, complications and outcomes were analyzed and compared between the 2 groups. COX regression model was used to analyze whether low calcium is an independent risk factors for poor outcomes in COVID-19 patients. ResultsThe low calcium group had significantly higher ratios of mechanical ventilation, extracorporeal membrane oxygenation (ECMO) and ICU occupancy (P<0.05); obviously higher incidences of sepsis, shock, hypoproteinemia, respiratory failure, coagulation disorders, acute kidney injury, acute myocardial injury, acute respiratory distress syndrome (ARDS), and even mortality (P<0.05); and remarkably longer length of hospital stay (P<0.001) when compared with the normal calcium group. The blood calcium level of mild and common, severe, and critical COVID-19 patients was 2.17 (2.11, 2.24), 2.13 (2.04, 2.21), and 2.03 (1.89, 2.18) mmol/L, respectively, and significant differences were seen among the patients (P<0.05). The calcium level was in a decreasing trend with the severity of COVID-19 (P<0.05). The calcium level was statistically lower in the dead patients than those survival [1.97 (1.87, 2.03) vs 2.17 (2.09, 2.23), P<0.001]. Multivariate Cox regression analysis indicated that serum calcium concentration <2.11 mmol/L was an independent risk factor for poor prognosis of COVID-19 (HR=5.695, 95%CI :2.363~13.725, P<0.001). ConclusionLow blood calcium level is an independent risk factor for poor prognosis in COVID-19 patients. Correction for hypocalcemia may be an important strategy to improve the prognosis of COVID-19 patients.

更新日期/Last Update: 2021-04-22