基于2023年新定义的COVID-19住院的固体器官移植接受者中的ARDS
Jun Tang1, Yang Zhou1, Linmei Gong1
1Department of Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, China; Hunan Provincial Center for Intensive Care Medicine and Clinical Research in Smart Healthcare, Changsha, China; Center for Smart Intensive Care Clinical Medicine Research, Central South University, Changsha, China.
Heart & lung : the journal of critical care
|April 11, 2024
概括
患有COVID-19的固体器官移植接受者 (SOTR) 患有急性呼吸窘迫综合征 (ARDS) 的风险较高. 脑血管疾病,高白细胞计数,低白蛋白和高IL-6水平预测SOTR中ARDS的发展.
科学领域:
- 移植医学 移植医学
- 传染病 传染病 传染病
- 关键护理医学 关键护理医学
背景情况:
- 固体器官移植接受者 (SOTR) 面临SARS-CoV-2感染严重并发症的风险.
- COVID-19对免疫力低下的人群构成重大威胁,包括SOTRs.
研究的目的:
- 在SOTRs中描述SARS-CoV-2感染的临床表现.
- 在COVID-19后的SOTR中,使用最新的ARDS定义来确定急性呼吸窘迫综合征 (ARDS) 的独立风险因素.
主要方法:
- 分析了358个感染SARS-CoV-2的SOTR队列,分为ARDS (n=81) 和非ARDS (n=277) 组.
- 人口,临床,实验室和治疗数据在各组之间进行了比较.
- 使用后勤回归和名图模型来识别风险因素并预测ARDS概率.
主要成果:
- 患有SARS-CoV-2的住院SOTR中,有22.6%的人患有ARDS.
- 患有ARDS的患者表现出更多的并发症,较低的淋巴细胞和白蛋白,但较高的白细胞,肌素,尿素,尿酸和炎症标志物.
- 独立的ARDS风险因素包括脑血管疾病,白细胞计数,白蛋白水平和IL-6水平,名谱达到0.81.6的AUC.
结论:
- 大脑血管疾病,白细胞计数升高,白蛋白水平降低和高IL-6是COVID-19的SOTR中ARDS的显著独立风险因素.
- 这些因素可以在预测模型中用于在这个脆弱人群中早期检测ARDS.
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