新型冠状病毒病 2019（COVID-19）相关住院的危险因素：COVID-19 相关住院监测网络和行为危险因素监测系统。
Risk Factors for Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System.
机构信息
COVID-NET Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
US Public Health Service, Rockville, Maryland, USA.
出版信息
Clin Infect Dis. 2021 Jun 1;72(11):e695-e703. doi: 10.1093/cid/ciaa1419.
BACKGROUND
Data on risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization are needed to guide prevention efforts and clinical care. We sought to identify factors independently associated with COVID-19-associated hospitalizations.
METHODS
Community-dwelling adults (aged ≥18 years) in the United States hospitalized with laboratory-confirmed COVID-19 during 1 March-23 June 2020 were identified from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a multistate surveillance system. To calculate hospitalization rates by age, sex, and race/ethnicity strata, COVID-NET data served as the numerator and Behavioral Risk Factor Surveillance System estimates served as the population denominator for characteristics of interest. Underlying medical conditions examined included hypertension, coronary artery disease, history of stroke, diabetes, obesity, severe obesity, chronic kidney disease, asthma, and chronic obstructive pulmonary disease. Generalized Poisson regression models were used to calculate adjusted rate ratios (aRRs) for hospitalization.
RESULTS
Among 5416 adults, hospitalization rates (all reported as aRR [95% confidence interval]) were higher among those with ≥3 underlying conditions (vs without) (5.0 [3.9-6.3]), severe obesity (4.4 [3.4-5.7]), chronic kidney disease (4.0 [3.0-5.2]), diabetes (3.2 [2.5-4.1]), obesity (2.9 [2.3-3.5]), hypertension (2.8 [2.3-3.4]), and asthma (1.4 [1.1-1.7]), after adjusting for age, sex, and race/ethnicity. Adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults aged ≥65 or 45-64 years (vs 18-44 years), males (vs females), and non-Hispanic black and other race/ethnicities (vs non-Hispanic whites).
CONCLUSIONS
Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.
背景
为了指导预防措施和临床护理，我们需要了解与 2019 年冠状病毒病（COVID-19）相关的住院的危险因素。我们旨在确定与 COVID-19 相关的住院治疗独立相关的因素。
方法
从 COVID-19 相关住院监测网络（COVID-NET）中确定了 2020 年 3 月 1 日至 6 月 23 日期间，美国因实验室确诊的 COVID-19 住院的社区居民成年人（年龄≥18 岁）。为了按年龄、性别和种族/族裔分层计算住院率，COVID-NET 数据作为分子，行为风险因素监测系统的估计数作为感兴趣特征的人口分母。检查的基础医疗条件包括高血压、冠状动脉疾病、中风史、糖尿病、肥胖、重度肥胖、慢性肾脏病、哮喘和慢性阻塞性肺疾病。使用广义泊松回归模型计算住院的调整后率比（aRR）。
结果
在 5416 名成年人中，有≥3 种基础疾病（与无基础疾病相比）（5.0 [3.9-6.3]）、重度肥胖症（4.4 [3.4-5.7]）、慢性肾脏病（4.0 [3.0-5.2]）、糖尿病（3.2 [2.5-4.1]）、肥胖症（2.9 [2.3-3.5]）、高血压（2.8 [2.3-3.4]）和哮喘（1.4 [1.1-1.7]）的住院率较高，在调整年龄、性别和种族/族裔后。在调整个体基础医疗条件存在的情况下，年龄≥65 岁或 45-64 岁（与 18-44 岁相比）、男性（与女性相比）以及非西班牙裔黑人和其他种族/族裔（与非西班牙裔白人相比）的住院率较高。
结论
我们的研究结果阐明了具有更高住院风险的人群，这些人群可能受益于有针对性的预防和治疗干预。
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