墨西哥新冠病毒检测呈阳性患者中合并症的影响：一项全国队列的回顾性分析

IMPACT OF COMORBIDITIES IN MEXICAN SARS-COV-2-POSITIVE PATIENTS: A RETROSPECTIVE ANALYSIS IN A NATIONAL COHORT.

作者信息

Kammar-García Ashuin, Vidal-Mayo José de J, Vera-Zertuche Juan M, Lazcano-Hernández Martín, Vera-López Obdulia, Segura-Badilla Orietta, Aguilar-Alonso Patricia, Navarro-Cruz Addi R

机构信息

Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City, Mexico.

Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.

出版信息

Rev Invest Clin. 2020;72(3):151-158. doi: 10.24875/RIC.20000207.

DOI:10.24875/RIC.20000207

PMID:32584330

Abstract

BACKGROUND

The coronavirus disease 2019 outbreak is a significant challenge for health-care systems around the world.

OBJECTIVE

The objective of the study was to assess the impact of comorbidities on the case fatality rate (CFR) and the development of adverse events in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Mexican population.

MATERIALS AND METHODS

We analyzed the data from 13,842 laboratory-confirmed SARS-CoV-2 patients in Mexico between January 1, 2020, and April 25, 2020. We investigated the risk of death and the development of adverse events (hospitalization, pneumonia, orotracheal intubation, and intensive care unit [ICU] admission), comparing the number of comorbidities of each patient.

RESULTS

The patient mean age was 46.6 ± 15.6 years, 42.3% (n = 5853) of the cases were women, 38.8% of patients were hospitalized, 4.4% were intubated, 29.6% developed pneumonia, and 4.4% had critical illness. The CFR was 9.4%. The risk of hospitalization (odds ratio [OR] = 3.1, 95% confidence interval [CI]: 2.7-3.7), pneumonia (OR = 3.02, 95% CI: 2.6-3.5), ICU admission (OR = 2, 95% CI: 1.5-2.7), and CFR (hazard ratio = 3.5, 95% CI: 2.9-4.2) was higher in patients with three or more comorbidities than in patients with 1, 2, or with no comorbidities.

CONCLUSIONS

The number of comorbidities may be a determining factor in the clinical course and its outcomes in SARS-CoV-2-positive patients.

摘要

背景

2019年冠状病毒病疫情对全球医疗系统构成重大挑战。

目的

本研究旨在评估合并症对墨西哥人群中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阳性患者的病死率（CFR）及不良事件发生情况的影响。

材料与方法

我们分析了2020年1月1日至2020年4月25日期间墨西哥13842例实验室确诊的SARS-CoV-2患者的数据。我们通过比较每位患者的合并症数量，调查了死亡风险及不良事件（住院、肺炎、气管插管和重症监护病房[ICU]收治）的发生情况。

结果

患者平均年龄为46.6±15.6岁，42.3%（n = 5853）的病例为女性，38.8%的患者住院，4.4%接受气管插管，29.6%发生肺炎，4.4%患有危重症。病死率为9.4%。合并症有三种或更多的患者发生住院（比值比[OR]=3.1，95%置信区间[CI]：2.7 - 3.7）、肺炎（OR = 3.02，95% CI：2.6 - 3.5）、入住ICU（OR = 2，95% CI：1.5 - 2.7）和病死率（风险比 = 3.5，95% CI：2.9 - 4.2）的风险高于合并症有1种、2种或无合并症的患者。