858例奥密克戎变异株新型冠状病毒感染住院患者死亡转归影响因素分析

Risk Factors and Their Influence Analysis on Mortality of 858 COVID-19 Pneumonia Patients with Omicron Variant

本文主要通过回顾性研究新型冠状病毒感染(奥密克戎流行毒株)患者临床资料,探讨患者死亡的影响因素。以2022年12月至2023年1月在广西医科大学第二附属医院收治的经基因测序诊断为奥密克戎变异株新型冠状病毒感染患者906例为研究对象,根据纳入标准和排除标准,最终纳入患者858例,其中809例患者好转并出院,49例患者死亡。回顾性分析比较出院患者和死亡患者临床资料,并进行多因素逻辑回归分析患者死亡的影响因素。结果显示,两组患者在年龄(t=-0.640)、接种新冠疫苗(χ^(2)=7.673)、高血压(χ^(2)=9.557)、糖尿病(χ^(2)=11.092)、脑梗(χ^(2)=5.810)、发热(χ^(2)=14.418)、呼吸困难(χ^(2)=56.878)、味觉异常/丧失(χ^(2)=5.876)、肺部啰音(χ^(2)=27.655)及意识障碍(χ^(2)=48.084)上存在显著差异(P<0.05)。多因素逻辑回归分析显示,年龄(OR=1.034,95%CI:1.010-1.060,P=0.007)、发热(OR=2.905,95%CI:1.279-6.790,P=0.012)、呼吸困难(OR=4.773,95%CI:1.866-11.858,P=0.001)和意识障碍(OR=31.326,95%CI:6.255-159.336,P=0.000)是患者死亡的独立危险因素;接种新冠疫苗(OR=0.376,95%CI:0.178-0.797,P=0.010)是独立保护因素。奥密克戎变异株新型冠状病毒感染的老年患者,如未接种过疫苗,当出现发热、呼吸困难和意识障碍等症状时,其死亡的可能性大,应警惕并及时采取针对性干预措施,改善患者预后。

In this article,the clinical data of patients with Corona Virus Disease 2019(COVID-19,Omichen epidemic strain)were retrospectively studied to explore the influencing factors of death.A total of 906 COVID-19 patients with Omicron variant diagnosed by gene sequencing in the Second Affiliated Hospital of Guangxi Medical University from December 2022 to January 2023 were taken as research subjects.Through inclusion criteria and exclusion criteria,858 patients were finally included,of which 809 patients improved and discharged,and 49 patients died.The clinical data of discharged patients and dead patients were retrospectively analyzed,and the influencing factors of death were analyzed by multivariate logistic regression.The results showed that there were significant differences between the two groups in age(t=-0.640),vaccination with new coronavirus vaccine(χ^(2)=7.673),hypertension(χ^(2)=9.557),diabetes(χ^(2)=11.092),cerebral infarction(χ^(2)=5.810),fever(χ^(2)=14.418),dyspnea(χ^(2)=56.878),taste abnormality/loss(χ^(2)=5.876),pulmonary rales(χ^(2)=27.655)and disturbance of consciousness(χ^(2)=48.084)(P<0.05).Multivariate logistic regression analysis showed that age(OR=1.034,95%CI:1.010-1.060,P=0.007),fever(OR=2.905,95%CI:1.279-6.790,P=0.012),dyspnea(OR=4.773,95%CI:1.866-11.858,P=0.001)and disturbance of consciousness(OR=31.326,95%CI:6.255-159.336,P=0.000)were independent risk factors for the death of patients;COVID-19 vaccination(OR=0.376,95%CI:0.178-0.797,P=0.010)was an independent protective factor.If elderly patients infected with the COVID-19(Omicron variant)have not been vaccinated,they are more likely to die when they have symptoms such as fever,dyspnea and disturbance of consciousness.We should be vigilant and take targeted intervention in time to improve the prognosis of patients.