40例新型冠状病毒肺炎患者住院中期胸部CT表现严重程度的影响因素分析

Analysis on the influencing factors of the chest CT with mid-hospitalization in 40 COVID-19 patients

目的分析新型冠状病毒肺炎(COVID-19)患者的临床特征,探讨与住院中期胸部CT表现严重程度有关的影响因素。方法回顾性收集2020年1月28日至3月15日收治具有完整临床资料、住院第6~10天的胸部CT(住院中期胸部CT)及实验室检查结果的COVID-19患者40例。依据胸部CT表现所示肺内病灶及其累及范围,将患者分为胸部CT轻度组(19例)和胸部CT重度组(21例)。采用多因素Logistic回归分析住院中期胸部CT表现严重程度的影响因素。结果两组患者性别构成、暴露史、合并并发症、发病至入院时间、临床症状、实验室检查指标、入院时病情分型差异均无统计学意义(P>0.05)。胸部CT重度组患者住院时间较胸部CT轻度组偏长,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,与胸部CT轻度组相比,男性、合并并发症更容易造成COVID-19患者住院中期胸部CT重度表现(P<0.05),并且胸部CT重度组患者年龄偏大,病毒排毒时间更长(P<0.05)。结论与住院中期胸部CT轻度组相比,胸部CT重度组男性、合并并发症比例更高,且年龄偏大,病毒排毒时间更长。结合胸部CT的优势特点,可以应用胸部CT辅助临床对COVID-19患者进行更加科学精准的防控。

Objective To analyzed the clinical characteristics of COVID-19 patients and to explore the influencing factors related to the severity of chest CT findings in mid-hospitalization.Methods Forty COVID-19 patients with complete clinical data,chest CT test results and the laboratory examination results of mid-hospitalization at 6-10 days from January 28 to March 15,2020 were retrospectively collected.All patients were divided into mild chest CT group and severe chest CT group according to chest CT.Logistic regression analysis was used to analyze the influencing factors related to the severity of chest CT during the mid-hospitalization.Results Gender,exposure history,complication,time from onset to admission,clinical symptoms,laboratory test results and disease classification were no significant differences between the two groups(P>0.05).Compared with patients in mild chest CT group,patients in the severe chest CT group showed a longer time of hospital stay(P<0.05).Multivariate Logistics regression showed that male,patients with complications were more likely to cause severe chest CT manifestations during the mid-hospitalization(P<0.05).Patients in severe chest CT group were older and had a longer time of virus efflux(P<0.05).Conclusion Compared with the mild chest CT group,the severe chest CT group had a higher proportion of male and complication,older age,and longer time of virus efflux.Combined with the advantages of chest CT,chest CT can be used to assist clinic for more scientific and accurate prevention and control of COVID-19.