病毒和宿主因素与COVID-19住院患者的死亡率有关
Neil R Aggarwal1, Jacquie Nordwall2, Dominique L Braun3
1Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
概括
高水平的SARS-CoV-2核体抗原 (病毒Ag),病毒RNA和互白素-6 (IL-6) 与住院COVID-19患者的死亡风险增加有关. 这些因素,以及呼吸支需求和功能障碍,表明潜在的治疗点.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 患有急性COVID-19住院成人的持续死亡率需要了解疾病机制.
- 住院患者治疗COVID-19 (TICO/ACTIV-3) 试验为调查死亡风险因素提供了一个平台.
研究的目的:
- 确定与入院COVID-19患者90天死亡风险相关的病毒相关和宿主反应因素.
- 评估基线病毒标志物和炎症标志物的预后意义在急性COVID-19中.
主要方法:
- 从TICO/ACTIV-3试验中对2625名因急性SARS-CoV-2感染住院的成年人的二次分析.
- 收集了基线临床变量,上呼吸道SARS-CoV-2病毒RNA,抗SARS-CoV-2抗体,SARS-CoV-2核体抗原 (病毒Ag) 和互白素-6 (IL-6).
- 使用单变量和多变量Cox比例危险模型来评估与90天死亡率的关联.
主要成果:
- 增加的SARS-CoV-2核体抗原 (病毒Ag),病毒RNA和IL-6水平与增加的死亡风险有显著联系.
- 需要呼吸支 (氧气治疗,非侵入性通风或高流量鼻) 和功能障碍的存在也是死亡率的强有力的预测因素.
- 病毒Ag,病毒RNA和IL-6的特定值显示出死亡率的显著调整危险比率.
结论:
- 病毒标记物 (Ag,RNA) 和宿主炎症标记物 (IL-6) 的基线水平与住院COVID-19患者的90天死亡率密切相关.
- 这些发现突出了潜在的病原体和宿主反应治疗点,用于管理严重的急性COVID-19.
- 这项研究强调了早期评估病毒载量和炎症状况对于预测结果的重要性.
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