哮喘和慢性阻塞性肺病并非SARS-CoV-2感染病例ICU住院和死亡的危险因素
2020/11/17
摘要
背景：与无阻塞性疾病的人相比，哮喘和COPD患者病毒感染的后果更为严重。
目的：评估阻塞性疾病是否是COVID-19导致ICU住院和死亡的危险因素。
方法：我们收集了自2020年3月18日至4月17日在列日大学医院住院的596例成年患者的电子病历中SARS-CoV2感染的数据。根据在COVID-19大流行之前出现的潜在呼吸系统疾病将患者分为3组。
结果：在需要住院治疗COVID-19的患者中，哮喘和COPD分别占9.6％和7.7％。在ICU住院的哮喘患者、COPD和无阻塞性气道疾病患者的比例分别为17.5％、19.6％和14％。三分之一的COPD患者在住院期间死亡，而只有7.0％的哮喘患者和13.6％的无气道阻塞的患者死于SARS-CoV2。多变量分析表明，哮喘、COPD、吸入性皮质类固醇治疗和口服皮质类固醇治疗不是ICU入院或死亡的独立危险因素。男性(优势比[OR]:1.9；95%置信区间[CI]: 1.1-3.2)和肥胖(OR:8.5；95%CI:5.1-14.1)是ICU入院的预测因子，而男性(OR: 1.9; 95%CI:1.1-3.2)、老年(OR:1.9；95%CI:1.6-2.3)、心脏病(OR:1.8；95%CI: 1.1-3.1)、免疫抑制疾病(OR: 3.6；95%可信区间:1.5-8.4)是死亡的独立预测因子。
结论： 哮喘和COPD不是与SARS-CoV2感染相关的ICU入院和死亡的危险因素。
Asthma and COPD are not risk factors for ICU stay and death in case of SARS-CoV-2 infection
Calmes Doriane , Graff Sophie , Maes Nathalie, Frix Anne-Noëlle, Thys Marie, Bonhomme Olivier, Berg Julien, Debruche Mathieu, Gester Fanny, Henket Monique, Paulus Virginie, Duysinx Bernard, Heinen Vincent, Nguyen Dang Delphine, Paulus Astrid, Quaedvlieg Valérie, Vaillant Frederique, Van Cauwenberge Hélène, Malaise Michel, Gilbert Alisson, Ghuysen Alexandre, Gillet Pierre, Moutschen Michel, Misset Benoit, Sibille Anne, Guiot Julien, Corhay Jean-Louis, Louis Renaud, Schleich Florence.
Abstract
BACKGROUND: Asthmatics and COPD patients have more severe outcomes with viral infections than people without obstructive disease.
OBJECTIVE: To evaluate if obstructive diseases are risk factors for ICU stay and death due to COVID19.
METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University hospital of Liege between 18th of March and 17th of April 2020 for SARS-CoV2 infection. We classified patients in three groups according to the underlying respiratory disease, present prior to COVID19 pandemics.
RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7% respectively. The proportions of asthmatics, COPD and patients without obstructive airway disease hospitalized in ICU were 17.5%, 19.6% and 14% respectively. One third of COPD patients died during hospitalization while only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, ICS treatment and OCS treatment were not independent risk factors for ICU admission or death. Male gender (OR:1.9; 95%CI: 1.1 to 3.2) and obesity (OR:8.5; 95%CI: 5.1 to 14.1) were predictors of ICU admission while male gender (OR1.9; 95%CI: 1.1-3.2), older age (OR:1.9; 95%CI: 1.6-2.3), cardiopathy (OR: 1.8; 95%CI: 1.1-3.1) and immunosuppressive diseases (OR: 3.6; 95%CI: 1.5-8.4) were independent predictors of death.
CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection.
背景：与无阻塞性疾病的人相比，哮喘和COPD患者病毒感染的后果更为严重。
目的：评估阻塞性疾病是否是COVID-19导致ICU住院和死亡的危险因素。
方法：我们收集了自2020年3月18日至4月17日在列日大学医院住院的596例成年患者的电子病历中SARS-CoV2感染的数据。根据在COVID-19大流行之前出现的潜在呼吸系统疾病将患者分为3组。
结果：在需要住院治疗COVID-19的患者中，哮喘和COPD分别占9.6％和7.7％。在ICU住院的哮喘患者、COPD和无阻塞性气道疾病患者的比例分别为17.5％、19.6％和14％。三分之一的COPD患者在住院期间死亡，而只有7.0％的哮喘患者和13.6％的无气道阻塞的患者死于SARS-CoV2。多变量分析表明，哮喘、COPD、吸入性皮质类固醇治疗和口服皮质类固醇治疗不是ICU入院或死亡的独立危险因素。男性(优势比[OR]:1.9；95%置信区间[CI]: 1.1-3.2)和肥胖(OR:8.5；95%CI:5.1-14.1)是ICU入院的预测因子，而男性(OR: 1.9; 95%CI:1.1-3.2)、老年(OR:1.9；95%CI:1.6-2.3)、心脏病(OR:1.8；95%CI: 1.1-3.1)、免疫抑制疾病(OR: 3.6；95%可信区间:1.5-8.4)是死亡的独立预测因子。
结论： 哮喘和COPD不是与SARS-CoV2感染相关的ICU入院和死亡的危险因素。
(中日友好医院呼吸与危重症医学科 王静茹 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2020 Oct 7;S2213-2198(20)31093-X. doi: 10.1016/j.jaip.2020.09.044.)
(J Allergy Clin Immunol Pract. 2020 Oct 7;S2213-2198(20)31093-X. doi: 10.1016/j.jaip.2020.09.044.)
Asthma and COPD are not risk factors for ICU stay and death in case of SARS-CoV-2 infection
Calmes Doriane , Graff Sophie , Maes Nathalie, Frix Anne-Noëlle, Thys Marie, Bonhomme Olivier, Berg Julien, Debruche Mathieu, Gester Fanny, Henket Monique, Paulus Virginie, Duysinx Bernard, Heinen Vincent, Nguyen Dang Delphine, Paulus Astrid, Quaedvlieg Valérie, Vaillant Frederique, Van Cauwenberge Hélène, Malaise Michel, Gilbert Alisson, Ghuysen Alexandre, Gillet Pierre, Moutschen Michel, Misset Benoit, Sibille Anne, Guiot Julien, Corhay Jean-Louis, Louis Renaud, Schleich Florence.
Abstract
BACKGROUND: Asthmatics and COPD patients have more severe outcomes with viral infections than people without obstructive disease.
OBJECTIVE: To evaluate if obstructive diseases are risk factors for ICU stay and death due to COVID19.
METHODS: We collected data from the electronic medical record from 596 adult patients hospitalized in University hospital of Liege between 18th of March and 17th of April 2020 for SARS-CoV2 infection. We classified patients in three groups according to the underlying respiratory disease, present prior to COVID19 pandemics.
RESULTS: Among patients requiring hospitalization for COVID19, asthma and COPD accounted for 9.6% and 7.7% respectively. The proportions of asthmatics, COPD and patients without obstructive airway disease hospitalized in ICU were 17.5%, 19.6% and 14% respectively. One third of COPD patients died during hospitalization while only 7.0% of asthmatics and 13.6% of patients without airway obstruction died due to SARS-CoV2. The multivariate analysis showed that asthma, COPD, ICS treatment and OCS treatment were not independent risk factors for ICU admission or death. Male gender (OR:1.9; 95%CI: 1.1 to 3.2) and obesity (OR:8.5; 95%CI: 5.1 to 14.1) were predictors of ICU admission while male gender (OR1.9; 95%CI: 1.1-3.2), older age (OR:1.9; 95%CI: 1.6-2.3), cardiopathy (OR: 1.8; 95%CI: 1.1-3.1) and immunosuppressive diseases (OR: 3.6; 95%CI: 1.5-8.4) were independent predictors of death.
CONCLUSION: Asthma and COPD are not risk factors for ICU admission and death related to SARS-CoV2 infection.
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婴儿期鼻咽微生物群的发育模式与哮喘风险相关
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