在低收入和中等收入国家预测COVID-19相关的肺性阿斯伯吉洛斯风险:一项匹配的病例控制研究
Merlin Moni1, Dipu T Sathyapalan1, Fabia Edathadathil2
1Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
一个新的预测得分识别了COVID-19相关的肺阿斯伯吉洛症 (CAPA) 的关键风险因素,这是一种严重的真菌感染. 这种工具有助于早期发现和治疗CAPA,特别是在资源较少的环境中,有可能改善患者的治疗结果.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 相关的肺炎 (CAPA) 是一种严重的,危及生命的真菌感染.
- 在低收入和中等收入国家对CAPA的研究特别稀缺.
研究的目的:
- 开发和验证用于识别CAPA高风险患者的预测得分.
- 评估CAPA对死亡率和重症监护室 (ICU) 入院的影响.
主要方法:
- 一个追溯匹配的病例控制研究,涉及南印度95例CAPA病例和95例控制.
- 使用2020年欧洲医学真菌学联合会/国际人类和动物真菌学学会标准对CAPA进行分类.
- 基于基线风险因素的预测得分的开发,并对共变量调整进行反向概率加权.
主要成果:
- 确定了CAPA的主要风险因素:淋巴缺血,欧洲癌症研究和治疗组织的风险因素,以及广泛的抗生素使用.
- 细菌共同感染显示出对CAPA的保护作用.
- 预测模型表现出强的表现 (AUC 82%) 并表明CAPA显著增加死亡率和ICU转移.
结论:
- 开发的预测得分是在资源有限的环境中早期识别CAPA的宝贵工具.
- 这种风险评分的进一步验证可以显著改善患者的治疗结果和CAPA的临床管理.
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