需住院治疗的COVID-19肺炎哮喘患者的特征和结局
2020/08/20
摘要
背景：病毒性呼吸道感染是哮喘加重的主要原因。哮喘患者由于SARS-CoV-2感染而出现严重肺炎时，其发展为哮喘急性加重的易感性尚不清楚。本研究的目的是调查在法国巴黎2020年春季爆发期间需要住院的COVID-19肺炎哮喘患者的特征和结局。
方法：于2020年3月15日至4月15日在法国巴黎萨克莱大学的Bicêtre医院进行了一项前瞻性队列研究。纳入所有既往有哮喘病史的SARS-CoV-2感染住院患者。
结果：在768例住院患者中，37例（4.8%）报告有哮喘病史，其中有85％的病例由呼吸专科医生确诊。患者主要为女性（70%），非吸烟者（85%），中位年龄为54岁（四分位间距，IQR 42-67）。患者均未出现哮喘急性发作。22位（59%）有合并症，31位（84%）体重指数≥25kg·m -2。最常见的合并症是肥胖（36%），高血压（27％）和糖尿病（19%）。所有患者胸部CT均确诊为COVID-19肺炎。嗜酸细胞减少是典型的生物学特征，中位数为0 / mm3（IQR 0-0）。重症监护室收治了11例患者（30％），其中3例死于（8.1％）合并症。
结论：由于SARS-CoV-2感染而需要住院的重症肺炎患者中，哮喘患者的发病率未见明显升高。不良结局主要出现在有合并症的患者中。
Characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who require hospitalization
Antoine Beurnier, Etienne-Marie Jutant, Mitja Jevnikar, Athénaïs Boucly, Jérémie Pichon, Mariana Preda, Marie Frank, Jérémy Laurent, Christian Richard, Xavier Monnet, Jacques Duranteau, Anatole Harrois, Marie-Camille Chaumais, Marie-France Bellin, Nicolas Noël, Sophie Bulifon, Xavier Jaïs, Florence Parent, Andrei Seferian, Laurent Savale, Olivier Sitbon, David Montani, Marc Humbert
Abstract
Background: Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of asthmatics to develop an exacerbation when they present with severe pneumonia due to SARS-CoV-2 infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France.
Methods: A prospective cohort follow-up was carried out from March 15 to April 15, 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included.
Results: Among 768 hospitalised patients, 37 (4.8%) reported a history of asthma, which had been previously confirmed by a pulmonologist in 85% of cases. Patients were mainly female (70%), non-smokers (85%), with a median age of 54 years (interquartile range, IQR 42-67). None of them presented with an asthma exacerbation. Twenty-two (59%) had major comorbidities and 31 (84%) had a body mass index ≥25 kg·m-2. The most common comorbidities were obesity (36%), hypertension (27%) and diabetes (19%). All patients had a confirmed diagnosis of COVID-19 pneumonia on computed tomography of the chest. Eosinopenia was a typical biologic feature with a median count of 0/mm3 (IQR 0-0). Eleven patients (30%) were admitted in intensive care unit with three death (8.1%) occurring in the context of comorbidities.
Conclusion: Asthmatics were not overrepresented among patients with severe pneumonia due to SARS-CoV-2 infection who required hospitalisation. Worst outcomes were observed mainly in patients with major comorbidities.
背景：病毒性呼吸道感染是哮喘加重的主要原因。哮喘患者由于SARS-CoV-2感染而出现严重肺炎时，其发展为哮喘急性加重的易感性尚不清楚。本研究的目的是调查在法国巴黎2020年春季爆发期间需要住院的COVID-19肺炎哮喘患者的特征和结局。
方法：于2020年3月15日至4月15日在法国巴黎萨克莱大学的Bicêtre医院进行了一项前瞻性队列研究。纳入所有既往有哮喘病史的SARS-CoV-2感染住院患者。
结果：在768例住院患者中，37例（4.8%）报告有哮喘病史，其中有85％的病例由呼吸专科医生确诊。患者主要为女性（70%），非吸烟者（85%），中位年龄为54岁（四分位间距，IQR 42-67）。患者均未出现哮喘急性发作。22位（59%）有合并症，31位（84%）体重指数≥25kg·m -2。最常见的合并症是肥胖（36%），高血压（27％）和糖尿病（19%）。所有患者胸部CT均确诊为COVID-19肺炎。嗜酸细胞减少是典型的生物学特征，中位数为0 / mm3（IQR 0-0）。重症监护室收治了11例患者（30％），其中3例死于（8.1％）合并症。
结论：由于SARS-CoV-2感染而需要住院的重症肺炎患者中，哮喘患者的发病率未见明显升高。不良结局主要出现在有合并症的患者中。
(中日友好医院呼吸与危重症医学科 李红雯 摘译 林江涛 审校 )
(Eur Respir J. 2020 Jul 30;2001875. doi: 10.1183/13993003.01875-2020.)
(Eur Respir J. 2020 Jul 30;2001875. doi: 10.1183/13993003.01875-2020.)
Characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who require hospitalization
Antoine Beurnier, Etienne-Marie Jutant, Mitja Jevnikar, Athénaïs Boucly, Jérémie Pichon, Mariana Preda, Marie Frank, Jérémy Laurent, Christian Richard, Xavier Monnet, Jacques Duranteau, Anatole Harrois, Marie-Camille Chaumais, Marie-France Bellin, Nicolas Noël, Sophie Bulifon, Xavier Jaïs, Florence Parent, Andrei Seferian, Laurent Savale, Olivier Sitbon, David Montani, Marc Humbert
Abstract
Background: Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of asthmatics to develop an exacerbation when they present with severe pneumonia due to SARS-CoV-2 infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France.
Methods: A prospective cohort follow-up was carried out from March 15 to April 15, 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included.
Results: Among 768 hospitalised patients, 37 (4.8%) reported a history of asthma, which had been previously confirmed by a pulmonologist in 85% of cases. Patients were mainly female (70%), non-smokers (85%), with a median age of 54 years (interquartile range, IQR 42-67). None of them presented with an asthma exacerbation. Twenty-two (59%) had major comorbidities and 31 (84%) had a body mass index ≥25 kg·m-2. The most common comorbidities were obesity (36%), hypertension (27%) and diabetes (19%). All patients had a confirmed diagnosis of COVID-19 pneumonia on computed tomography of the chest. Eosinopenia was a typical biologic feature with a median count of 0/mm3 (IQR 0-0). Eleven patients (30%) were admitted in intensive care unit with three death (8.1%) occurring in the context of comorbidities.
Conclusion: Asthmatics were not overrepresented among patients with severe pneumonia due to SARS-CoV-2 infection who required hospitalisation. Worst outcomes were observed mainly in patients with major comorbidities.
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基于肺外可治疗性状的哮喘表型鉴定
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难治性哮喘的新观点；基于性别和年龄的哮喘发病表型
