Abstract:

Objective To describe the clinical characteristics of the coronavirus disease 2019 (COVID-19) patients with a history of stroke, to improve clinical treatment efficacy. Methods The COVID-19 patients with a history of stroke from Wuhan Huoshenshan Hospital were included in this retrospective study. All patients were divided into common type group and severe type group, according to the clinical classification criteria of diagnosis and treatment of COVID-19 (revised version 5). The medical history, clinical manifestation, complications and laboratory examination of two groups were analyzed. Results A total of eligible 60 patients were included, with 31 cases in common type group and 29 cases in severe type group. In terms of clinical outcomes, 54 cases were cured, 3 cases were transferred for further treatment, and 3 cases died. Compared to the common patients, the severe patients were more prone to develop respiratory failure (20.7% vs 3.2%, P =0.049), acute myocardial injury (17.2% vs 0, P =0.022) and other complications. In terms of laboratory examination, the levels of D dimer, lactate dehydrogenase and CRP in severe patients were higher than that in common patients, and the above differences were all statistically significant. Increased neutrophil count (OR 1.799, 95%CI 1.208-2.678, P =0.004) and reduced lymphocyte count (OR 0.038, 95%CI 0.004-0.359, P =0.004) were independent risk factors for severe pneumonia. Conclusions COVID-19 patients with a history of stroke had more underlying diseases. Increased neutrophil count and decreased lymphocyte count are independent risk factors for severe pneumonia.

Key words: Coronavirus disease 2019; Cerebral infarction; Clinical feature

摘要：

目的 分析具有脑梗死病史的2019冠状病毒病（coronavirus disease 2019，COVID-19）（即新型冠状病 毒肺炎）患者临床特点，以提高临床救治率。 方法 回顾性分析武汉火神山医院既往有脑梗死病史的COVID-19患者的临床资料，根据《新型冠 状病毒肺炎诊疗方案（试行第五版修正版）》临床分型标准，分为普通型和重型两组，比较两组患者 的一般病史资料、临床表现、合并症及实验室检查的特点。 结果 共纳入60例符合入组条件的患者，其中普通型31例，重型29例。临床结局出院54例，转院3 例，死亡3例。重型患者较普通型患者更易出现呼吸衰竭（20.7% vs 3.2%，P =0.049）、急性心肌损伤 （17.2% vs 0，P =0.022）等并发症。实验室检查方面，重型患者中性粒细胞计数、D-二聚体、乳酸脱氢 酶、CRP水平高于普通型患者，差异有统计学意义。中性粒细胞计数（OR 1.799，95%CI 1.208～2.678， P =0.004）、淋巴细胞计数（OR 0.038，95%CI 0.004～0.359，P =0.004）为重型患者的独立影响因素。 结论 既往有脑梗死病史的COVID-19患者合并基础疾病较多，中性粒细胞计数升高和淋巴细胞计 数降低是重型患者的独立影响因素。

关键词: 2019冠状病毒病; 脑梗死; 临床特征