[1]楼淑萍,刘攀越,陈辉.新型冠状病毒肺炎患者发生重症、危重症危险因素的Meta分析[J].第三军医大学学报,2020,42(14):1469-1475.
 LOU Shuping,LIU Panyue,CHEN Hu.Risk factors of severe and critical coronavirus disease 2019: a meta-analysis[J].J Third Mil Med Univ,2020,42(14):1469-1475.
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新型冠状病毒肺炎患者发生重症、危重症危险因素的Meta分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
42卷
期数:
2020年第14期
页码:
1469-1475
栏目:
特别报道
出版日期:
2020-07-30

文章信息/Info

Title:
Risk factors of severe and critical coronavirus disease 2019: a meta-analysis
作者:
楼淑萍刘攀越陈辉
华中科技大学同济医学院公共卫生学院:儿少卫生与妇幼保健学系1,伤害控制研究中心
Author(s):
LOU Shuping LIU Panyue CHEN Hu

Department of Maternal and Child Health, 2Center of Injury Prevention, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China

关键词:
新型冠状病毒肺炎重型危险因素Meta分析
Keywords:
coronavirus disease 2019 severe cases risk factors meta-analysis
分类号:
R181.23; R563.1
文献标志码:
A
摘要:

目的通过Meta分析研究现有的数据,寻找重/危重型新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)患者的危险因素。方法制定原始文献的纳入标准、排除标准,系统检索中国期刊全文数据库(CNKI)、万方数据库、中国生物医学文献服务系统(CBMdisc)、PubMed和EMbase数据库,建立文献库。采用R-3.4.2软件,对符合纳入标准的病例对照文献进行异质性检验,并计算各临床表现和影响因素在重/危重症患者与普通轻型患者中的分布情况、合并效应值(OR)和95%可信区间(CI)。结果本研究共纳入14篇文献共计3 506名患者,分析了31项影响因素,Meta分析的主要结果显示:重/危重型COVID-19患者较普通/轻型患者的年龄大12.62岁(P<0.05),男性(OR=1.510)比例更高,入院时乳酸脱氢酶>250 U/L(OR=4.177),胸部CT双侧病变(OR=2.260),患有心血管疾病(OR=4.873)、慢阻肺(OR=3.425)、高血压(OR=2.734)、恶性肿瘤(OR=2.629)、糖尿病(2.428)基础疾病的患者发展为重/危重型的可能性更大。入院时,重型组患者临床表现为呼吸困难、发热、乏力、咳痰、干咳,与普通/轻型患者相比差异有统计学意义(P<0.05)。结论乳酸脱氢酶高、胸部CT双侧病变、患有基础疾病等均是COVID-19重/危重型患者的危险因素,未发现保护因素。

Abstract:

ObjectiveTo analyze the risk factors for severe and critical coronavirus disease 2019 (COVID-19) based on current research findings. MethodsWe searched CNKI, Wanfang, CBMdisc, PubMed and Embase databases for original articles according to the prespecified inclusion and exclusion criteria. After testing for heterogeneity of all the eligible studies, we analyzed the distribution of the clinical manifestations and the potential risk factors for severe and critical conditions of COVID-19 and calculated the pooled OR with 95%CI using R-3.4.2 software. ResultsWe retrieved 14 eligible studies from the databases involving a total of 3 506 patients, and analyzed 31 potential risk factors for severe and critical COVID-19. Meta-analysis showed that the patients with severe or critical COVID-19 were 12.62 years older than those with common or mild type of the disease (P<0.05). Compared with the patients with common or mild type of COVID-19, the patients in severe or critical conditions were more likely to be male (OR=1.510) and had a LDH>250 U/L at admission (OR=4.177), bilateral lesions on chest CT (OR=2.260), and underlying conditions including cardiovascular disease (OR=4.873), COPD (OR=3.425), hypertension (OR=2.734), malignant tumor (OR=2.629), and diabetes (OR=2.428). Significant differences were noted in the clinical manifestations including dyspnea, fever, fatigue, sputum, and dry cough between the patients with severe/critical conditions and those with milder conditions when they were admitted (P<0.05). ConclusionAn elevated LDH level (> 250 U/L), bilateral lesions on chest CT and presence of underlying diseases at admission are all risk factors for severe and critical COVID-19, for which no protective factors have yet been identified.
 

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更新日期/Last Update: 2020-07-23