BMC Gastroenterology:胃肠道症状与 COVID-19患者的住院率、死亡率和结局风险降低有关

2022-03-20 MedSci原创 MedSci原创

康人的胃肠道内寄居着种类繁多的微生物,即肠道菌群。肠道中的“好”细菌对人体健康发挥积极作用,而“坏”细菌则会促进多种(肠道)疾病。

      研究表明,COVID-19新冠肺炎的死亡率估计在 1.4% 到 61% 之间,病死率在 3.4% 到 11% 之间。最初,COVID-19 最常见的症状是发烧、咳嗽和呼吸急促。一段时间后,出现无症状感染、寒战、鼻塞、乏力、肌痛、咽痛、恶心、呕吐、腹泻、流涕等症状。COVID-19 病毒通过破坏肺泡上皮细胞和内皮细胞导致急性呼吸窘迫综合征 (ARDS)。一些研究报告称,75% 的 COVID-19 患者会出现一种或多种胃肠道 (GI) 症状。腹泻是胃肠道感染症状患者最常见的症状,影响 11.5% 的患者。大约 5% 的 COVID-19 患者和 20% 的住院患者需要重症监护治疗。因此,本研究旨在比较具有各种胃肠道和呼吸道临床症状的患者的死亡率和住院率差异,以确定有死亡风险的患者并采取适当的干预措施。

 

      为此,研究人员分析了 2020 年 2 月 20 日至 2021 年 3 月 10 日 COVID-19 患者的临床病历数据。根据患者的疾病症状,将患者分为四类:只有胃肠道症状的患者、只有呼吸道症状的患者、两者都有的患者症状,以及有其他症状的患者。逻辑回归分析用于评估组与结果的关联。

 

      本项研究共纳入来自 23 家医院的 42964 名患者,其中 26.5% 的患者至少有一种或多种胃肠道症状。在所有患者中,51.58% 的患者住院,其中 22.8% 的患者至少有一种或多种胃肠道症状。与有其他症状的患者相比,胃肠道症状显着降低了死亡率(OR 0.72,95% CI 0.56-0.92),但呼吸道症状增加了新冠肺炎患者的死亡率(OR 1.36, 95% CI 1.24-1.50)。此外,与有其他症状的患者相比,同时有呼吸道和胃肠道症状的患者的优势比明显增加(1.52:1.31-1.78)。

图:胃肠道症状与 COVID-19患者的住院率和死亡率关系

 

      本项研究表明,COVID-19 患者入院时出现胃肠道症状与较低的住院率和死亡率相关;然而,这部分患者有更高的呼吸道症状几率。

 

 

原始出处:

Alireza Delavari. Et al. Gastrointestinal symptoms are associated with a lower risk of hospitalization and mortality and outcomes in COVID-19. BMC Gastroenterology.2022.

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likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Tue Jun 21 12:31:52 CST 2022, time=2022-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2073540, encodeId=e3b920e354072, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri May 20 00:31:52 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297577, encodeId=6aa7129e57767, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346376, encodeId=54b513463e660, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505391, encodeId=ac211505391b3, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568211, encodeId=ab7615682116e, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1820747, encodeId=84981820e4743, content=<a href='/topic/show?id=0c6a1009105e' target=_blank style='color:#2F92EE;'>#风险降低#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100910, encryptionId=0c6a1009105e, topicName=风险降低)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fd18451, createdName=xre2008, createdTime=Sat Jun 11 08:31:52 CST 2022, time=2022-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1713043, encodeId=41f51e13043a4, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, 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style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346376, encodeId=54b513463e660, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1505391, encodeId=ac211505391b3, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568211, encodeId=ab7615682116e, content=<a href='/topic/show?id=40de83346a3' target=_blank style='color:#2F92EE;'>#胃肠道症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83346, encryptionId=40de83346a3, topicName=胃肠道症状)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=)]
    2022-05-20 许安
  6. 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createdAvatar=null, createdBy=eede15326817, createdName=yinhl1983, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=)]
  7. 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style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346376, encodeId=54b513463e660, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Tue Mar 22 12:31:52 CST 2022, time=2022-03-22, status=1, ipAttribution=), 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  8. 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