停止新冠队列研究：对莫斯科市谢马什克夫大学医院网络收治的3480例疑似2019冠状病毒病（COVID-19）感染患者的观察性研究。

Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection.

作者信息

Munblit Daniel, Nekliudov Nikita A, Bugaeva Polina, Blyuss Oleg, Kislova Maria, Listovskaya Ekaterina, Gamirova Aysylu, Shikhaleva Anastasia, Belyaev Vladimir, Timashev Peter, Warner John O, Comberiati Pasquale, Apfelbacher Christian, Bezrukov Evgenii, Politov Mikhail E, Yavorovskiy Andrey, Bulanova Ekaterina, Tsareva Natalya, Avdeev Sergey, Kapustina Valentina A, Pigolkin Yuri I, Dankwa Emmanuelle A, Kartsonaki Christiana, Pritchard Mark G, Fomin Victor, Svistunov Andrey A, Butnaru Denis, Glybochko Petr

机构信息

Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Inflammation, Repair, and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.

出版信息

Clin Infect Dis. 2021 Jul 1;73(1):1-11. doi: 10.1093/cid/ciaa1535.

DOI:10.1093/cid/ciaa1535

PMID:33035307

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7665333/

Abstract

BACKGROUND

The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking.

METHODS

We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020.

RESULTS

Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47).

CONCLUSIONS

Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.

摘要

背景

2019冠状病毒病（COVID-19）在俄罗斯人群中的流行病学、临床病程及转归尚不清楚。缺乏关于实际环境中实验室确诊与临床诊断的COVID-19之间差异的信息。

方法

我们从2020年4月8日至5月28日期间在莫斯科因疑似COVID-19感染而连续入院的成年患者的病历中提取数据。

结果

在4261例因疑似COVID-19住院的患者中，3480例患者（中位年龄56岁；四分位间距45-66岁）有转归数据。最常见的合并症为高血压、肥胖、慢性心血管疾病和糖尿病。一半患者（n = 1728）逆转录酶-聚合酶链反应（RT-PCR）呈阳性，而1748例RT-PCR呈阴性，但有临床症状及提示COVID-19的特征性计算机断层扫描征象。在单纯临床诊断或严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RT-PCR呈阳性的患者之间，症状频率、实验室检查结果及院内死亡危险因素方面未发现显著差异。在多变量逻辑回归模型中，以下因素与院内死亡相关：年龄较大（每增加1岁；比值比，1.05；95%置信区间，1.03-1.06）、男性（1.71；1.24-2.37）、慢性肾脏病（2.99；1.89-4.64）、糖尿病（2.1；1.46-2.99）、慢性心血管疾病（1.78；1.24-2.57）和痴呆（2.73；1.34-5.47）。