陕西省神经科新型冠状病毒感染住院患者的治疗总结

Treatment Summary of Hospitalized Patients with Novel Coronavirus Infection in Neurology Department in Shaanxi Province

摘要: 目的：比较使用与未使用抗新型冠状病毒治疗、使用与未使用激素治疗、使用与未使用抗生素治疗、使用与未使用中药治疗及接种与未接种新型冠状病毒疫苗的各型新型冠状病毒感染住院患者住院天数及治疗结局的差别；比较接种与未接种新型冠状病毒疫苗的新型冠状病毒感染诊断分型(轻型、中型、重型及危重型)的差别。阶段性总结新型冠状病毒感染住院患者的治疗情况及疗效分析；并促进各医院新型冠状病毒感染整体诊治水平的提高，指导康复及下一阶段可能出现高峰时的治疗。方法：回顾性收集并分析陕西省抗癫痫协会会员单位医院的其中10家医院的神经内科及神经外科在2022年12月13日~2023年1月31日期间收治的新型冠状病毒感染住院患者的临床资料，评价各型新型冠状病毒感染诊断分型中各治疗组疗效和接种疫苗对诊断分型的影响。结果：对363例患者临床资料进行统计学分析，在新型冠状病毒感染诊断分型为轻型的住院患者中，抗新型冠状病毒组与非抗新型冠状病毒组之间(P < 0.001)、激素组与非激素组之间(P = 0.006)的住院天数差别存在统计学意义，在新型冠状病毒感染诊断分型为轻型、中型及重型的住院患者中，抗生素组与非抗生素组之间(P < 0.001, P = 0.005, P = 0.045)的住院天数差别存在统计学意义，新型冠状病毒感染诊断分型为中型的住院患者中，疫苗组与非疫苗组之间(P = 0.024)的治疗结局存在组间差异性；相对于轻型，非疫苗组中诊断为危重型的可能性高于疫苗组(OR = 11.463, 95% CI 1.352~97.186, P = 0.025)。结论：新型冠状病毒感染诊断分型为轻型的住院患者应用抗新型冠状病毒治疗、激素治疗及抗生素治疗可能增加住院天数，新型冠状病毒感染诊断分型为中型和重型的住院患者应用抗生素治疗可能增加住院天数；新型冠状病毒感染诊断分型为中型的住院患者疫苗组相对于对照组，其治疗结局的阳性事件发生的可能性更大，接种疫苗可能对预防COVID-19感染后进展为危重型有一定正向作用。

Abstract: Objective: To compare the differences in the number of days of hospitalization and treatment outcomes in patients with the various diagnostic types of novel coronavirus infection with and without anti-novel coronavirus therapy, with and without hormone therapy, with and without antibiotic therapy, with and without traditional Chinese medicine, and vaccinated and unvaccinated against novel coronavirus; comparison of the diagnostic classification of novel coronavirus infections (mild, moderate, severe and critical) between those vaccinated and those not vaccinated against novel coronaviruses. We will summarize the treatment of hospitalized patients with novel coronavirus infections and analyze the therapeutic efficacy in a staged manner, and promote the improvement of the overall diagnosis and treatment of novel coronavirus infections in hospitals to guide the rehabilitation and the treatment of novel coronavirus infections in the next stage, when the peak may occur. Methods: Retrospective collection and analysis of clinical data of patients hospitalized with novel coronavirus infections admitted to the Department of Neurology and Department of Neurosurgery of 10 of the hospitals that are members of the Shaanxi Provincial Anti-Epilepsy Association during the period of December 13, 2022~January 31, 2023, to evaluate the efficacy of treatment groups in the diagnostic typing of novel coronavirus infections of each type and the effect of vaccination on the diagnostic typing. Results: The clinical data of 363 patients were statistically analyzed. Among the hospitalized patients whose diagnostic classification of novel coronavirus infection was mild, there were statistically significant differences in hospital days between the anti-novel coronavirus group and the non-anti-novel coronavirus group (P < 0.001) and between the hormone group and the non-hormone group (P = 0.006). There was a statistically significant difference in hospital days between the antibiotic group and the non-antibiotic group among the hospitalized patients whose diagnostic classification of novel coronavirus infection was mild, moderate and severe (P < 0.001, P = 0.005, P = 0.045), and between-group variability in treatment outcomes between the vaccine and non-vaccine groups among hospitalized patients whose diagnostic typology of novel coronavirus infection was medium (P = 0.024); the likelihood of a diagnosis of critical illness was higher in the non-vaccine than in the vaccine group, relative to the mild type (OR = 11.463, 95% CI 1.352~97.186, P = 0.025). Conclusions: The application of anti-novel coronavirus therapy, hormone therapy and antibiotic therapy may increase hospital days in hospitalized patients with a diagnostic classification of mild forms of novel coronavirus infection, and the application of antibiotic therapy in hospitalized patients with a diagnostic classification of moderate and severe forms of novel coronavirus infection; the vaccine group of hospitalized patients with a diagnostic classification of moderate forms of novel coronavirus infection was more likely to have a positive outcome of the treatment, relative to the control group. Vaccination may have a positive effect on preventing progression to critical type after COVID-19 infection.