关键词: 新型冠状病毒肺炎, 重症及危重症, 实验室指标, 病亡, 危险因素

Abstract:

Objective To analyze clinical characteristics and risk factors associated with the death of critically ill patients with COVID-19,so as to effectively identify severe patients with potential death threat and provide the basis for effective treatment. Methods A total of 146 patients with severe COVID-19 treated in our hospital from January 23,2020 to February 12,2020 were enrolled in this study. There were 98 patients in survival group and 48 patients in death group. Age,sex,symptoms,basic diseases,blood indexes,concurrent infection and secondary infection were compared between the two groups. Risk factors related to death were analyzed by means of logistics regression. Results There were significant differences in age,gender,chest distress,shortness of breath,and gastrointestinal infection between the two groups（P<0.05）. The proportion of patients with basic diseases in the death group was higher than that in the survival group. The incidence of pulmonary lesion was 100% in the death group and 90.82% in the survival group. The levels of white blood cell count,D-dimer,aspartate aminotransferase,blood urea nitrogen,creatinine,cardiac troponin I,B-type natriuretic peptide,blood glucoseand procalcitoninin the death group were significantly higher than those in the survival group（P<0.05）,while lymphocyte percentage,total protein,albuminand cholesterolin the death group were significantly lower than those in the survival group（P<0.05）. Compared with the survival group,the infection rate of other respiratory pathogens was significantly reduced in the death group,while the secondary infection rates of fungi and bacteria were significantly increased. Logistic regression analysis showed that age,gender（male）,no gastrointestinal reaction,two or more basic diseases,low L% and high GLU were the risk factors for the death of patients with severe COVID-19. Conclusion Elderly,male,no gastrointestinal reaction,two or more basic diseases,low L% and high GLU all indicate the increased mortality risk in critically ill patients with COVID-19.

Key words: Corona Virus Disease 2019, Severe and critical illness, Laboratory indexes, Death, Risk factors