亚特兰大市区感染新冠病毒疾病患者的住院及死亡特征与风险因素

Characteristics and Risk Factors for Hospitalization and Mortality among Persons with COVID-19 in Atlanta Metropolitan Area.

作者信息

Chishinga Nathaniel, Gandhi Neel R, Onwubiko Udodirim N, Telford Carson, Prieto Juliana, Smith Sasha, Chamberlain Allison T, Khan Shamimul, Williams Steve, Khan Fazle, Shah Sarita

机构信息

Fulton County Government, Atlanta, Georgia.

Office of Epidemiology, Fulton County Board of Health, Atlanta, Georgia.

出版信息

medRxiv. 2020 Dec 16:2020.12.15.20248214. doi: 10.1101/2020.12.15.20248214.

BACKGROUND

We present data on risk factors for severe outcomes among patients with coronavirus disease 2019 (COVID-19) in the southeast United States (U.S.).

OBJECTIVE

To determine risk factors associated with hospitalization, intensive care unit (ICU) admission, and mortality among patients with confirmed COVID-19.

DESIGN

A retrospective cohort study.

SETTING

Fulton County in Atlanta Metropolitan Area, Georgia, U.S.

PATIENTS

Community-based individuals of all ages that tested positive for SARS-CoV-2.

MEASUREMENTS

Demographic characteristics, comorbid conditions, hospitalization, ICU admission, death (all-cause mortality), and severe COVID-19 disease, defined as a composite measure of hospitalization and death.

RESULTS

Between March 2 and May 31, 2020, we included 4322 individuals with various COVID-19 outcomes. In a multivariable logistic regression random-effects model, patients in age groups ≥45 years compared to those <25 years were associated with severe COVID-19. Males compared to females (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI]: 1.1-1.6), non-Hispanic blacks (aOR 1.9, 95%CI: 1.5-2.4) and Hispanics (aOR 1.7, 95%CI: 1.2-2.5) compared to non-Hispanic whites were associated with increased odds of severe COVID-19. Those with chronic renal disease (aOR 3.6, 95%CI: 2.2-5.8), neurologic disease (aOR 2.8, 95%CI: 1.8-4.3), diabetes (aOR 2.0, 95%CI: 1.5-2.7), chronic lung disease (aOR 1.7, 95%CI: 1.2-2.3), and "other chronic diseases" (aOR 1.8, 95%CI: 1.3-2.6) compared to those without these conditions were associated with increased odds of having severe COVID-19.

CONCLUSIONS

Multiple risk factors for hospitalization, ICU admission, and death were observed in this cohort from an urban setting in the southeast U.S. Improved screening and early, intensive treatment for persons with identified risk factors is urgently needed to reduce COVID-19 related morbidity and mortality.

背景

我们展示了美国东南部2019冠状病毒病（COVID-19）患者严重后果的风险因素数据。

目的

确定确诊COVID-19患者中与住院、重症监护病房（ICU）收治及死亡相关的风险因素。

设计

一项回顾性队列研究。

地点

美国佐治亚州亚特兰大市富尔顿县。

患者

社区中所有年龄的SARS-CoV-2检测呈阳性的个体。

测量指标

人口统计学特征、合并症、住院情况、ICU收治情况、死亡（全因死亡率）以及严重COVID-19疾病，定义为住院和死亡的综合指标。

结果

在2020年3月2日至5月31日期间，我们纳入了4322名有不同COVID-19结局的个体。在多变量逻辑回归随机效应模型中，年龄≥45岁的患者与<25岁的患者相比，与严重COVID-19相关。男性与女性相比（调整后的优势比[aOR]为1.4，95%置信区间[CI]：1.1 - 1.6），非西班牙裔黑人（aOR为1.9，95%CI：1.5 - 2.4）以及西班牙裔（aOR为1.7，95%CI：1.2 - 2.5）与非西班牙裔白人相比，严重COVID-19的发生几率增加。与无这些疾病的人相比，患有慢性肾病（aOR为3.6，95%CI：2.2 - 5.8）、神经系统疾病（aOR为2.8，95%CI：1.8 - 4.3）、糖尿病（aOR为2.0，95%CI：1.5 - 2.7）、慢性肺病（aOR为1.它与严重COVID-19的发生几率增加相关。

结论

在美国东南部城市地区的这一队列中观察到了住院、ICU收治和死亡的多种风险因素。迫切需要对具有确定风险因素的人群进行改进筛查以及早期、强化治疗，以降低与COVID-19相关的发病率和死亡率。 7）、慢性肺病（aOR为1.7，95%CI：1.2 - 2.3）以及“其他慢性病”（aOR为1.8，95%CI：1.3 - 2.6）与无这些疾病的人相比，严重COVID-19的发生几率增加。

结论

在美国东南部城市地区的这一队列中观察到了住院、ICU收治和死亡的多种风险因素。迫切需要对具有确定风险因素的人群进行改进筛查以及早期、强化治疗，以降低与COVID-19相关的发病率和死亡率。