在入院至ICU的重症患者中,基于和炎症入院参数进行聚类
Olivier Mascle1, Claire Dupuis1,2, Marina Brailova3
1CHU de Clermont-Ferrand, Service de Médecine Intensive et Réanimation, Clermont-Ferrand, France.
PloS one
|November 1, 2024
概括
这项研究确定了严重COVID-19的两个不同的患者群,揭示了免疫功能障碍和损伤风险的差异. 这些发现有助于解释急性损伤 (AKI) 变异性,并指导COVID-19患者未来的临床试验.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- COVID-19流行病与可变的急性损伤 (AKI) 发生率相关.
- 患者异质性是了解AKI变异性的关注点.
- 炎症生物标志物在COVID-19患者的结果中发挥作用.
研究的目的:
- 使用基线特征和炎症生物标志物识别严重COVID-19患者的同质子组 (集群).
- 在90天后 (MAKE-90) 进行重大脏不良事件的风险和确定集群之间的死亡率进行比较.
- 在严重的COVID-19患者中调查生物特征和事件风险.
主要方法:
- 在重症医疗重症监护病房 (MICU) 住院的严重COVID-19成年患者的单中心回顾性研究.
- 根据主要组件的等级聚类,用于根据接收特征,生物标志物和免疫/功能标志物来定义聚类.
- 结果包括MAKE-90和90天后记录的死亡率.
主要成果:
- 确定了三个群体;两个被完全描述 (群体1: 122名患者,群体2: 25名患者).
- 集群1:较少的器官功能障碍,中度免疫功能障碍,较低的死亡率和较低的MAKE-90发病率.
- 集群2:更严重的疾病严重程度,更高的免疫功能障碍,升高的suPAR和L-FABP/U Creat,增加的器官支持,更高的AKI发病率,90日死亡率和MAKE-90.
结论:
- 两个不同的重症COVID-19患者集群被确定具有不同的生物概况和事件风险.
- 这些集群可以帮助确定未来临床试验的目标人群.
- 了解这些群体可能会阐明在COVID-19患者中观察到的AKI发病率的变异性.
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