Boëlle Pierre-Yves, Delory Tristan, Maynadier Xavier, Janssen Cécile, Piarroux Renaud, Pichenot Marie, Lemaire Xavier, Baclet Nicolas, Weyrich Pierre, Melliez Hugues, Meybeck Agnès, Lanoix Jean-Philippe, Robineau Olivier
Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Assistance Publique - Hôpitaux de Paris, 75012 Paris, France.
Centre Hospitalier Annecy Genevois, 74370 Epagny-Metz-Tessy, France.
J Clin Med. 2020 Sep 29;9(10):3148. doi: 10.3390/jcm9103148.
Describing the characteristics of COVID-19 patients in the hospital is of importance to assist in the management of hospital capacity in the future. Here, we analyze the trajectories of 1321 patients admitted to hospitals in northern and eastern France. We found that the time from onset to hospitalization decreased with age, from 7.3 days in the 20-65 year-olds to 4.5 in the >80 year-olds ( < 0.0001). Overall, the length of stay in the hospital was 15.9 days, and the death rate was 20%. One patient out of four was admitted to the intensive care unit (ICU) for approximately one month. The characteristics of trajectories changed with age: fewer older patients were admitted to the ICU and the death rate was larger in the elderly. Admission shortly after onset was associated with increased mortality (odds-ratio (OR) = 1.8, Confidence Interval (CI) 95% [1.3, 2.6]) as well as male sex (OR = 2.1, CI 95% [1.5, 2.9]). Time from admission within the hospital to the transfer to ICU was short. The age- and sex-adjusted mortality rate decreased over the course of the epidemic, suggesting improvement in care over time. In the SARS-CoV-2 epidemic, the urgent need for ICU at admission and the prolonged length of stay in ICU are a challenge for bed management and organization of care.
描述新冠病毒肺炎住院患者的特征对于未来协助管理医院床位至关重要。在此，我们分析了法国北部和东部地区1321例住院患者的病程轨迹。我们发现，从发病到住院的时间随年龄增长而缩短，20至65岁患者为7.3天，80岁以上患者为4.5天（<0.0001）。总体而言，住院时间为15.9天，死亡率为20%。四分之一的患者入住重症监护病房（ICU）约一个月。病程轨迹特征随年龄变化：入住ICU的老年患者较少，且老年人死亡率更高。发病后不久入院与死亡率增加相关（优势比（OR）=1.8，95%置信区间（CI）[1.3, 2.6]），男性也是如此（OR = 2.1，CI 95% [1.5, 2.9]）。从入院到转入ICU的时间较短。经年龄和性别调整后的死亡率在疫情期间有所下降，表明护理水平随时间推移有所改善。在新冠疫情中，入院时对ICU的迫切需求以及在ICU的长时间停留对床位管理和护理组织构成了挑战。
