新型冠状病毒肺炎重型和危重型患者病毒转阴时间的影响因素分析

Analysis of Factors Influencing Viral Shedding Time in Severe and Critical COVID-19 Patients

目的:探讨新型冠状病毒肺炎重型和危重型患者病毒转阴时间的影响因素。方法:回顾性收集28例新型冠状病毒肺炎重型和危重型患者的临床资料,分析影响患者病毒转阴时间的因素。结果:28例患者的病毒转阴平均时间为24.0 ±9.0天,最长和最短转阴时间分别为41天和12天。病毒转阴时间 ≥ 24天和【24天患者分别为13例和15例,两组患者的空腹血糖(P = 0.001)、D-二聚体(P = 0.025)、淋巴细胞计数(P = 0.049)、中性粒细胞率(P = 0.019)、临床分型(P = 0.006)、糖尿病患者数(P = 0.029) 6项指标差异具有统计学意义。空腹血糖与病毒转阴时间正相关,相关系数为0.468,P = 0.012。多因素Logistic回归分析提示,患者转入重症24小时内的空腹血糖偏高是影响病毒转阴时间的独立危险因素(OR = 1.680, 95% CI为1.011~2.792,P = 0.045)。空腹血糖预测病毒转阴时间 ≥ 24天的曲线下面积(AUC)为0.887 (95% CI为0.711~0.975,P 【0.001),最佳截断值为7.33 mmol/L,敏感度和特异度分别为84.6%和86.7%。结论:新型冠状病毒肺炎重型和危重型患者转入重症24小时内空腹血糖高是影响病毒转阴时间的危险因素,临床救治该类患者时应该给予关注。

Objective: To investigate the factors influencing the time of viral shedding in severe and critical COVID-19 patients. Methods: Clinical data of 28 patients with severe and critical COVID-19 were collected retrospectively to analyze the factors affecting the time of viral shedding. Results: This study observed the mean duration of 2019-nCov RNA shedding was 24.0 ±9.0 days in survivor patients, the longest and shortest observed duration of viral shedding were 41 days and 12 days. There were 13 and 15 patients with viral shedding time ≥ 24 and