韩国全国性基于人群的回顾性研究使用韩国健康保险审查和评估服务（HIRA）数据库：冠状病毒疾病患者的临床特征和死亡及严重程度的危险因素。
Clinical Characteristics and Risk Factors for Fatality and Severity in Patients with Coronavirus Disease in Korea: A Nationwide Population-Based Retrospective Study Using the Korean Health Insurance Review and Assessment Service (HIRA) Database.
机构信息
Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan 49241, Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea.
出版信息
Int J Environ Res Public Health. 2020 Nov 18;17(22):8559. doi: 10.3390/ijerph17228559.
BACKGROUND
We aimed to investigate the clinical characteristics and risk factors for fatality and severity in these patients.
METHODS
In this nationwide population-based retrospective study, we investigated the data of 7339 laboratory-confirmed COVID-19 patients, aged ≥ 18 years, using the Korean Health Insurance Review and Assessment Service (HIRA) database. Comorbidities and medications used were identified using HIRA codes, and severe COVID-19 was defined as that requiring oxygen therapy, mechanical ventilator, cardiopulmonary resuscitation, or extracorporeal membrane oxygenation. The outcomes were death due to COVID-19 and COVID-19 severity.
RESULTS
Mean patient age was 47.1 years; 2970 (40.1%) patients were male. Lopinavir/ritonavir, hydroxychloroquine, antibiotics, ribavirin, oseltamivir, and interferon were administered to 35.8%, 28.4%, 38.1%, 0.1%, 0.3%, and 0.9% of patients, respectively. After adjusting for confounding factors, diabetes mellitus, chronic kidney disease, previous history of pneumonia, aging, and male were significantly associated with increased risk of death and severe disease. No medication was associated with a reduced risk of fatality and disease severity.
CONCLUSIONS
We found several risk factors for fatality and severity in COVID-19 patients. As the drugs currently used for COVID-19 treatment have not shown significant efficacy, all efforts should be made to develop effective therapeutic modalities for COVID-19.
背景
我们旨在研究这些患者的病死率和严重程度的临床特征和危险因素。
方法
在这项全国范围内基于人群的回顾性研究中，我们使用韩国健康保险审查与评估服务（HIRA）数据库调查了 7339 名年龄≥18 岁的实验室确诊的 COVID-19 患者的数据。使用 HIRA 代码确定合并症和使用的药物，将严重 COVID-19 定义为需要氧疗、机械通气、心肺复苏或体外膜氧合的患者。结局是 COVID-19 导致的死亡和 COVID-19 严重程度。
结果
患者平均年龄为 47.1 岁；3570 名（40.1%）患者为男性。洛匹那韦/利托那韦、羟氯喹、抗生素、利巴韦林、奥司他韦和干扰素分别在 35.8%、28.4%、38.1%、0.1%、0.3%和 0.9%的患者中使用。在调整混杂因素后，糖尿病、慢性肾脏病、肺炎既往史、年龄和男性与死亡和严重疾病的风险增加显著相关。没有药物与病死率和疾病严重程度降低相关。
结论
我们发现了 COVID-19 患者病死率和严重程度的几个危险因素。由于目前用于 COVID-19 治疗的药物尚未显示出显著疗效，因此应尽一切努力开发 COVID-19 的有效治疗方法。
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