Department of Medicine, Interfaith Medical Center, Brooklyn, New York.
Department of Pulmonology and Critical care, Interfaith Medical Center, Brooklyn, New York.
J Med Virol. 2021 Feb;93(2):812-819. doi: 10.1002/jmv.26306. Epub 2020 Oct 5.
There is limited data on the clinical presentation and predictors of mortality in the African-American (AA) patients hospitalized with coronavirus disease 2019 (COVID-19) despite the disproportionately higher burden and mortality. The aim of this study is to report on the clinical characteristics and the predictors of mortality in hospitalized AA patients with COVID-19 infection. In this retrospective cohort review, we included all AA patients with confirmed COVID-19 infection admitted to an inner-city teaching community hospital in New York city. Demographics, clinical presentation, baseline co-morbidities, and laboratory data were compared between survivors and non-survivors. The predictors of mortality were assessed using multivariate logistic regression analysis. Of the 408 (median age, 67 years) patients included, 276 (66.65%, median age 63 years) survived while 132 (33.35%, median age 71 years) died. The most common presenting symptoms were cough, myalgia, fever/chills, shortness of breath, and gastrointestinal symptoms (nausea, vomiting, diarrhea, and abdominal pain), with a prevalence of 62.50%, 43.87%, 53.68%, and 27.21%, respectively. Age (odds ratio [OR], 1.06; confidence interval [CI], 1.04-1.08; P < .001), body mass index (OR, 1.07; CI, 1.04-1.11; P < .001), elevated serum ferritin (OR, 1.99; CI, 1.08-3.66; P < .02), C-reactive protein (OR, 2.42; CI, 1.36-4.33; P < .01), and D-dimers (OR, 3.79; CI, 2.21-6.50; P < .001) at the time of presentation were identified as the independent predictors of mortality. Cough, shortness of breath, fever/chills, gastrointestinal symptoms, and myalgia were the predominant presentation among AAs hospitalized with COVID-19 infection. Advanced age, higher body mass index, elevated serum ferritin, C-reactive protein, and D-dimers are independent predictors of mortality among hospitalized AAs with COVID-19 infection.
在美国,尽管非裔美国人(African-American,AA)的新冠负担和死亡率明显更高,但有关其住院新冠患者的临床表现和死亡预测因素的数据却十分有限。本研究旨在报告住院新冠感染的 AA 患者的临床特征和死亡预测因素。在这项回顾性队列研究中,我们纳入了所有在纽约市一家市区教学社区医院住院的确诊新冠感染的 AA 患者。比较了幸存者和非幸存者之间的人口统计学、临床表现、基线合并症和实验室数据。使用多元逻辑回归分析评估了死亡的预测因素。在纳入的 408 名患者中(中位年龄为 67 岁),276 名(66.65%,中位年龄为 63 岁)存活,132 名(33.35%,中位年龄为 71 岁)死亡。最常见的首发症状为咳嗽、肌痛、发热/寒战、呼吸急促和胃肠道症状(恶心、呕吐、腹泻和腹痛),其发生率分别为 62.50%、43.87%、53.68%和 27.21%。年龄(比值比[OR],1.06;95%置信区间[CI],1.04-1.08;P<.001)、体重指数(OR,1.07;95%CI,1.04-1.11;P<.001)、血清铁蛋白升高(OR,1.99;95%CI,1.08-3.66;P<.02)、C 反应蛋白(OR,2.42;95%CI,1.36-4.33;P<.01)和 D-二聚体(OR,3.79;95%CI,2.21-6.50;P<.001)是死亡的独立预测因素。在住院新冠感染的 AA 患者中,咳嗽、呼吸急促、发热/寒战、胃肠道症状和肌痛是主要表现。年龄较大、体重指数较高、血清铁蛋白、C 反应蛋白和 D-二聚体升高是非住院新冠感染 AA 患者死亡的独立预测因素。