在第一波,第二波和第三波期间,严重病情的COVID-19患者的不变特征和生存率:一个潜在的观察队列
Alexis Ferré1, Myriam Lamamri1, Marc Delord2,3
1Intensive Care Unit, Versailles Hospital, Le Chesnay, France.
概括
尽管侵入性机械通风使用量下降,但COVID-19的生存率在前三次大流行浪潮中保持一致. 中间氨酸剂量改善了生存率,而HFNO和类固醇没有显著的益处.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 在COVID-19患者中,急性呼吸衰竭在整个大流行浪潮中呈现出各种特征和结果.
- 了解这些变化对于优化患者管理和资源配置至关重要.
研究的目的:
- 为了比较患者的特征和急性呼吸衰竭的结果由于COVID-19在第一个,第二个和第三个流行浪潮.
- 为了确定与重症COVID-19患者的90天生存相关的因素.
主要方法:
- 分析了2020年3月至2021年7月期间入院ICU的289名成年患者队列.
- 根据疫情浪潮,患者被分为三组:第1波 (W1),第2波 (W2) 和第3波 (W3).
- 采用多变量分析来确定与90天生存相关的因素.
主要成果:
- 住院死亡率为23.6%. 在不同波段 (W1: 27.4%,W2: 23.9%,W3: 22%) 中,90日死亡率相似.
- 侵袭性机械通风 (MV) 的使用在波的跨度下降.
- 与更高的90天存活率相关的因素包括中期肝素血栓预防 (OR: 3.21),而年龄较大,免疫缺陷,急性损伤和侵入性MV与更低的存活率相关.
结论:
- 在COVID-19急性呼吸衰竭患者的生存率在前三波中没有显著变化.
- 高流量鼻氧和静脉注射类固醇与90天生存率的改善无关.
- 血栓预防治疗中期肝素剂量与更好的90天生存率有关;建议进行进一步的多中心研究.
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