新型冠状病毒肺炎病例重症化影响因素及早期临床特征

  目的  通过收集分析荆州市新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）病例流行病学资料，寻找病例重症化的影响因素及早期临床特征。  方法  利用χ2检验单因素分析筛选、Logistic回归分析模型寻找COVID-19病例重症化的影响因素和早期临床特征。  结果  荆州市累计报告1 580例确诊病例及临床诊断病例，重症病例占比23.61%（373/1 580）。多因素分析结果显示年龄≥49岁（OR=2.342，95% CI:1.803~3.043）、确诊病例（OR=2.772，95% CI:1.735~4.428）、有心脑血管疾病（OR=2.872，95% CI:1.542~5.349）是COVID-19病例临床结局演化为重症的危险因素；淋巴细胞百分比降低（OR=1.881，95% CI:1.105~3.202）、发热（OR=1.845，95% CI:1.340~2.541）、乏力（OR=1.616，95% CI:1.246~2.097）、气促（OR=1.870，95% CI:1.197~2.923）是COVID-19病例临床结局演化为重症的早期临床特征。  结论  年老者、患心脑血管疾病的COVID-19病例及早期出现发热、乏力、气促、淋巴细胞比降低的COVID-19病例均需警惕其重症化演变。

Analysis of influencing factors and early clinical features of severe cases of COVID-19

  Objective  This paper aimed to found the risk factors and early clinical features of coronavirus disease 2019(COVID-19) severe cases by according to the epidemiological data of COVID-19 cases in Jingzhou City.  Objective  χ2 test and Logistic regression model analysis were used to sought the risk factors and early clinical features of COVID-19 cases.  Results  There were 1 580 confirmed and clinically diagnosed COVID-19 cases reported in Jingzhou City. The proportion of severe cases was 23.61% (373/1 580).Multivariate analysis showed that age ≥ 49 years (OR=2.342, 95% CI:1.803-3.043), confirmed cases (OR=2.772, 95% CI:1.735-4.428), cardiovascular and cerebrovascular diseases (OR=2.872, 95% CI:1.542-5.349) were the risk factors of COVID-19 severe cases, and lymphocyte percentage decrease (OR=1.881, 95% CI:1.105-3.202), fever (OR=1.845, 95% CI:1.340-2.541), fatigue (OR=1.616, 95% CI:1.246-2.097), chest tightness (OR=1.870, 95% CI:1.197-2.923) were the early clinical features of COVID-19 severe cases.  Conclusions  COVID-19 cases who were the el-derly, with cardiovascular diseases, and were fever, fatigue, chest tightness, and lymphocyte percentage decrease at early clinic stages should be on alert for its severe progression.