新型冠状病毒感染患者CT所示肺部炎症的风险因素分析

Risk factors of pulmonary inflammation diagnosed by chest CT image in SARS-CoV-2 infected patients

目的研究新型冠状病毒(SARS-CoV-2)感染患者胸部CT检查诊断为肺部炎症的相关风险因素。方法选取2022年5月20日至7月20日收治于上海某新冠定点医院的新型冠状病毒感染患者162例。根据胸部CT检查是否诊断为肺部炎症分为无CT肺部炎症组124例和有CT肺部炎症组38例,比较两组患者入院时的一般资料和实验室检测结果,通过单因素和多因素Logistic回归分析CT肺部炎症的相关风险因素。结果新冠患者无CT肺部炎症组和有CT肺部炎症组之间疫苗接种次数、住院天数、白细胞计数、淋巴细胞计数、血小板计数、丙氨酸氨基转移酶、L-γ-谷氨酰基转移酶、直接胆红素、IL-6和25羟维生素D水平差异均具有统计学意义(P<0.05)。新冠疫苗未接种、未完全接种和完全接种的新冠患者发生CT肺部炎症的比例分别为48.27%、30.95%和12.09%。单因素和多因素Logistic回归分析结果显示,新冠患者CT肺部炎症的风险因素包括年龄(OR=4.58,95%CI:1.31~16.04)、新冠疫苗是否接种完全(OR=0.46,95%CI:0.29~0.74)、IL-6(OR=6.82,95%CI:1.70~27.35)、铁蛋白(OR=5.03,95%CI:1.41~17.98)和C反应蛋白(OR=0.24,95%CI:0.06~0.91)水平。结论完全接种新冠疫苗能有效降低新冠患者CT肺部炎症的风险;年龄较大、C反应蛋白水平较低、IL-6和铁蛋白水平升高是新冠患者CT肺部炎症的独立风险因素。

Objective To analyze the risk factors of pulmonary inflammation diagnosed by chest CT image in SARS-CoV-2 infected patients.Methods A total of 162 SARS-CoV-2 infected patients who were admitted to a designated hospital in Shanghai from May 20,2022 to July 20,2022 were enrolled in this study.Based on the manifestation patterns of CT image,the patients were divided into two groups:124 cases without pulmonary inflammation and 38 cases with pulmonary inflammation.The general data and laboratory examination results of the patients in the two groups were compared,while single and multi-factor Logistic regression analyses were used to identify the risk factors associated with pulmonary inflammation diagnosed by chest CT in SARS-CoV-2 infected patients.Results There were statistically significant differences in vaccination times,hospitalization duration,the counts of white blood cell,lymphocyteand platelet,and the levels of alanine aminotransferase,L-γ-glutamyltransferase,direct bilirubin,interleukin-6 and 25-hydroxyvitamin D between the SARS-CoV-2 infected patients with and without pulmonary inflammation diagnosed by chest CT images(P<0.05).The proportions of the patients with pulmonary inflammation in those who were not received COVID-19 vaccination,not fully vaccinated and fully vaccinated were 48.27%,30.95%and 12.09%,respectively.Multi-factor logistic regression analysis showed that the risk factors for the patients with pulmonary inflammation diagnosed by chest CT included the following:age(OR=4.58,95%CI:1.31 to 16.04),COVID-19 vaccination(OR=0.46,95%CI:0.29 to 0.74),the levels of interleukin-6(OR=6.82,95%CI:1.70 to 27.35),ferritin(OR=5.03,95%CI:1.41 to 17.98)and C-reactive protein in serum(OR=0.24,95%CI:0.06-0.91).Conclusion Complete vaccination of COVID-19 should effectively reduce the occurrence of pulmonary inflammation diagnosed by chest CT in the SARS-CoV-2 infected patients.The older age,lower C-reactive protein levels and elevated levels of interleukin-6 and ferritin in serum may be the independent risk factors for the pulmonary inflammation diagnosed by chest CT in SARS-CoV-2 infected patients.