Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study
机构:[1]The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China,广东省中医院[2]Department of Clinical Epidemiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,广东省中医院[3]Department of Big Medical Data, Health Construction Administration Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,大德路总院科研广东省中医院[4]Department of Emergency, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,大德路总院急诊科大德路总院急诊科广东省中医院深圳市中医院深圳医学信息中心[5]Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,广东省中医院[6]State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China广东省中医院
Background and Purpose: Coronavirus disease 2019 (COVID-19) rapidly resulted in a pandemic. Information on patients with a history of cerebrovascular disease (CVD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. This study investigated the clinical features and the risk factors of developing adverse outcomes in patients with COVID-19 and with previous CVD.Methods: This was a single-center retrospective clinical study including all the confirmed cases of COVID-19 at Wuhan Huoshenshan Hospital from February 4 to April 7, 2020. Differences in clinical characteristics were compared between patients with and without a history of CVD. The incidences of severe events comprising all-cause death, intensive care unit admission, shock, and mechanical ventilation usage during hospitalization in two groups were compared using propensity score matching analysis and multivariate logistic regression analyses. Besides, the risk factors of developing severe events in patients with COVID-19 who also have history of CVD were analyzed.Results: A total of 2,554 consecutive patients were included in our study, of whom 109 (4.27%) had a medical history of CVD. Patients with CVD tend to be older and with more comorbidities, including hypertension, diabetes, coronary heart disease, and chronic obstructive pulmonary disease. The levels of white blood cell, neutrophil, C-reactive protein, creatine kinase isoenzymes, and lactate dehydrogenase were higher, whereas the levels of lymphocyte and albumin were lower in the CVD group. Compared to those without CVD, patients with CVD were more likely to have severe events after age matching (12.8 vs. 5.7%, P = 0.012). After adjusting for the confounding effects of age, sex, smoking, and comorbidities, the odds ratio for developing severe events with a history of CVD was 2.326 (95% CI, 1.168-4.630; P = 0.016). Besides, patients with CVD, either with decreased lymphocyte count (OR 9.192, 95% CI, 1.410-59.902, P = 0.020) or increased blood urea nitrogen (OR 5.916, 95% CI, 1.072-32.641, P = 0.041), had a higher risk of developing severe events during hospitalization.Conclusions: Patients with CVD history tend to have adverse clinical outcomes after being infected with SARS-COV-2. Decreased lymphocyte counts and increased blood urea nitrogen levels may be risk factors for adverse outcomes in patients with COVID-19, and had CVD.
基金:
National Natural Science
Foundation of China (Grant No. 81974559), Key Research
and Development Program of Guangdong Province (Grant No.
2020B1111100009), Guangdong Provincial Key Laboratory of
TCMResearch on Emergency (Grant No. 2017B030314176), and
the Natural Science Foundation of Guangdong Province (Grant
No. 2021A1515011480).
第一作者机构:[1]The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China,
共同第一作者:
通讯作者:
通讯机构:[5]Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China,[6]State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
推荐引用方式(GB/T 7714):
Li Mengzhen,He Zehui,Yang Jiecong,et al.Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study[J].FRONTIERS IN NEUROLOGY.2022,12:doi:10.3389/fneur.2021.706478.
APA:
Li, Mengzhen,He, Zehui,Yang, Jiecong,Guo, Qihua,Weng, Heng...&Guo, Jianwen.(2022).Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study.FRONTIERS IN NEUROLOGY,12,
MLA:
Li, Mengzhen,et al."Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study".FRONTIERS IN NEUROLOGY 12.(2022)