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中国新型冠状病毒(COVID-19)病死率的潜在危险因素:个体患者数据的汇总分析。

Potential risk factors for case fatality rate of novel coronavirus (COVID-19) in China: A pooled analysis of individual patient data.

机构信息

Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, No. 1 Yi Xue Yuan Road, Yuzhong District, Chongqing 400016, China.

Laboratory medicine, The First Affiliated Hospital of Chongqing Medical University, No. 1 Yi Xue Yuan Road, Yuzhong District, Chongqing 400016, China.

出版信息

Am J Emerg Med. 2020 Nov;38(11):2374-2380. doi: 10.1016/j.ajem.2020.08.039. Epub 2020 Aug 17.

Abstract

BACKGROUND AND OBJECTIVE

Since the first case of the pneumonia caused by 2019 novel coronavirus (COVID-19) is found in Wuhan, there have been more than 70,000 cases reported in China. This study aims to perform the meta-analysis of risk factors for the case fatality rate (CFR) of the 2019 novel coronavirus (COVID-19).

DESIGN AND METHODS

We have searched PubMed, Google scholar and medRxiv for the cohort studies involving risk factors for the CFR of COVID-19. This meta-analysis compares the risk factors of CFR between fatal patients and non-fatal patients.

RESULTS

Two cohort studies are included in this study. After comparing the patients between fatal cases and non-fatal cases, several important factors are found to significantly increase the CFR in patients with COVID-19, and include the age ranging 60-70 (OR = 1.85; 95% CI = 1.62 to 2.11; P < .00001) and especially≥70 (OR = 8.45; 95% CI = 7.47 to 9.55; P < .00001), sex of male (OR = 1.88; 95% CI = 1.30 to 2.73; P = .0008), occupation of retirees (OR = 4.27; 95% CI = 2.50 to 7.28; P < .00001), and severe cases (OR = 691.76; 95% CI = 4.82 to 99,265.63; P = .01). As the advancement of early diagnosis and treatment, the CFR after January 21 (or 22), 2020 is substantially decreased in COVID-19 than before (OR = 0.21; 95% CI = 0.19 to 0.24; P < .00001).

CONCLUSIONS

Several factors are confirmed to significantly improve the CFR in patients with COVID-19, which is very important for the treatment and good prognosis of these patients.

摘要

背景和目的

自首例 2019 年新型冠状病毒(COVID-19)引起的肺炎病例在武汉发现以来,中国已报告超过 7 万例。本研究旨在对 2019 年新型冠状病毒(COVID-19)病死率(CFR)的危险因素进行荟萃分析。

设计和方法

我们在 PubMed、Google Scholar 和 medRxiv 上搜索了涉及 COVID-19 CFR 危险因素的队列研究。这项荟萃分析比较了 COVID-19 死亡患者和非死亡患者的危险因素。

结果

本研究纳入了两项队列研究。在比较了死亡病例和非死亡病例的患者后,发现几个重要因素显著增加了 COVID-19 患者的 CFR,包括年龄在 60-70 岁之间(OR=1.85;95%CI=1.62 至 2.11;P<.00001)和≥70 岁(OR=8.45;95%CI=7.47 至 9.55;P<.00001),男性(OR=1.88;95%CI=1.30 至 2.73;P=.0008),退休人员(OR=4.27;95%CI=2.50 至 7.28;P<.00001)和重症病例(OR=691.76;95%CI=4.82 至 99265.63;P=.01)。随着早期诊断和治疗的进展,2020 年 1 月 21 日(或 22 日)以后 COVID-19 的 CFR 明显低于之前(OR=0.21;95%CI=0.19 至 0.24;P<.00001)。

结论

有几个因素被证实显著提高了 COVID-19 患者的 CFR,这对这些患者的治疗和良好预后非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/747d/7429563/85f199069015/gr1_lrg.jpg

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