由于COVID-19而入院的喘和COPD患者死亡率的差异
Yunqing Liu1, Haseena Rajeevan2, Michael Simonov3
1Department of Biostatistics, Yale School of Public Health, New Haven, Conn.
概括
患有慢性阻塞性肺病 (COPD) 的患者面临更高的COVID-19死亡率,而喘患者的风险较低. 在喘中常见的2型炎症可能会对严重的冠状病毒疾病2019 (COVID-19) 提供保护.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 患有喘和/或慢性阻塞性肺病 (COPD) 的患者患有严重的2019年新冠病毒病 (COVID-19) 的风险尚未得到充分确立.
- 了解这些风险对于在疫情期间管理患有先前存在的呼吸道疾病的患者至关重要.
研究的目的:
- 为了比较喘,COPD和没有呼吸道疾病的患者之间的住院COVID-19结果.
- 为了确定影响COVID-19严重程度的因素,在患有呼吸道疾病的患者.
主要方法:
- 一项回顾性队列研究包括8,395名2020年3月至2021年4月期间因COVID-19住院的患者.
- 国际疾病分类,第10次修订代码确定了呼吸道疾病的诊断.
- 死亡率和顺序器官衰竭评估 (SOFA) 评分进行了比较;后勤回归调整为混因素.
主要成果:
- 患有COPD的患者的SOFA得分较高 (中位数为0.86),调整后死亡率增加 (OR为1.40;P<.01).
- 喘患者的SOFA得分较低 (中位数为0.15),调整后死亡率降低 (OR为0.65;P=0.01).
- 血中异氨基酸细胞数≥200细胞/μL与不同组的较低死亡率有关;喘患者即使没有异氨基酸,也显示出保护作用.
结论:
- 在COPD患者中,COVID-19的严重程度增加,在喘患者中降低,独立于临床混因素.
- 这些发现表明,内在的免疫因素,如2型炎症,影响COVID-19在呼吸道疾病的严重程度.
- 喘,包括非酸性喘类型,似乎对严重的COVID-19有保护作用.
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