Office of Human Research, Memorial Healthcare System, 4411 Sheridan Street, Hollywood, FL, 33021, USA.
Division of Infectious Disease, Memorial Healthcare System, 5647 Hollywood Boulevard, Hollywood, FL, 33021, USA.
J Community Health. 2021 Aug;46(4):822-831. doi: 10.1007/s10900-020-00957-y. Epub 2021 Jan 7.
The novel coronavirus disease 2019 (COVID-19) continues to be a major public health concern. The aim of this study was to describe the presenting characteristics, epidemiology and predictors of outcomes among confirmed COVID-19 cases seen at a large community healthcare system which serves the epicenter and diverse region of Florida. We conducted a retrospective analysis of individuals with lab-confirmed SARS-CoV-2 infection who were seen, from March 2, 2020 to May 31, 2020, at Memorial Healthcare System in South Florida. Data was extracted from a COVID-19 registry of patients with lab-confirmed SARS-CoV-2 infection. Univariate and backward stepwise multivariate logistic regression models were used to determine predictors of key study outcomes. There were a total of 1692 confirmed COVID-19 patients included in this study. Increasing age was found to be a significant predictor of hospitalization, 30-day readmission and death. Having a temperature of 38 °C or more and increasing comorbidity score were also associated with an increased risk of hospitalization. Significant predictors of ICU admission included having a saturated oxygen level less than 90%, hypertension, dementia, rheumatologic disease, having a respiratory rate greater than 24 breaths per minute. Being of Hispanic ethnicity and immunosuppressant utilization greatly increased the risk of 30-day readmission. Having an oxygen saturation less than 90% and an underlying neurological disorder were associated with an increased likelihood of death. Results show that a patient's demographic, underlying condition and vitals at triage may increase or reduce their risk of hospitalization, ICU admission, 30-day readmission or death.
2019 年新型冠状病毒病（COVID-19）仍然是一个主要的公共卫生关注点。本研究的目的是描述在一个大型社区医疗保健系统中看到的确诊 COVID-19 病例的临床表现、流行病学和结局预测因素，该系统服务于佛罗里达州的震中和多样化地区。我们对 2020 年 3 月 2 日至 2020 年 5 月 31 日期间在南佛罗里达州纪念医疗保健系统就诊的实验室确诊 SARS-CoV-2 感染个体进行了回顾性分析。数据从 COVID-19 患者实验室确诊 SARS-CoV-2 感染登记处提取。使用单变量和向后逐步多变量逻辑回归模型来确定关键研究结局的预测因素。本研究共纳入 1692 例确诊 COVID-19 患者。研究发现，年龄增长是住院、30 天再入院和死亡的重要预测因素。体温 38°C 或更高以及合并症评分增加与住院风险增加相关。入住 ICU 的显著预测因素包括血氧饱和度低于 90%、高血压、痴呆、风湿性疾病、呼吸频率大于 24 次/分钟。西班牙裔和免疫抑制剂的使用大大增加了 30 天再入院的风险。血氧饱和度低于 90%和潜在的神经障碍与死亡的可能性增加相关。结果表明，患者的人口统计学、潜在疾病和分诊时的生命体征可能会增加或降低其住院、入住 ICU、30 天再入院或死亡的风险。
