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与 COVID-19 死亡风险增加相关的因素:基于确诊病例的生存分析。

Factors associated with increased risk of death from covid-19: a survival analysis based on confirmed cases.

机构信息

Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte - Natal (RN), Brasil.

出版信息

Rev Bras Epidemiol. 2021 Jan 6;23:e200106. doi: 10.1590/1980-549720200106. eCollection 2021.

DOI:10.1590/1980-549720200106
PMID:33439939
Abstract

OBJECTIVE

To perform a survival analysis of individuals diagnosed with COVID-19 identified by health information systems, analyzing the factors associated with the highest risk of death.

METHODS

Survival analysis of individuals notified with COVID-19 in Rio Grande do Norte State using data from the Health Information Systems for the surveillance of cases of and deaths from COVID-19. The dependent variable was the period until the outcome occurrence. The independent variables were sex, self-reported skin color, age group, residence in the capital, and the presence of comorbidities. For data analysis the Kaplan-Meyer method and Cox-time-dependent Regression Model for multivariate analysis were used, with the covariable "period since the event notification recorded in days".

RESULTS

Highest risk of death were observed in individuals aged 80 or older (HR = 8.06; p < 0.001), male (HR = 1.45, p < 0.001), non-white skin color (HR = 1.13; p < 0.033) or with no information (HR = 1.29; p < 0.001), with comorbidities (HR = 10.44; p < 0.001) or presence of comorbidities not reported (HR = 10.87; p < 0.001).

CONCLUSION

The highest risk of occurrence of deaths from COVID-19 was observed in older adults, especially those over 80, patients who have comorbidities, men, and of non-white skin color. From the identification of the profile of patients with a higher risk of death with the identification by the health system, specific strategies of health care must be taken to prevent the evolution to death in these cases.

摘要

目的

通过对健康信息系统识别的 COVID-19 个体进行生存分析,分析与死亡风险最高相关的因素。

方法

使用来自 COVID-19 病例和死亡监测卫生信息系统的数据,对在北里奥格兰德州被诊断为 COVID-19 的个体进行生存分析。因变量为出现结局的时间间隔。自变量为性别、自我报告的肤色、年龄组、居住地是否在首府,以及是否存在合并症。数据分析采用 Kaplan-Meier 法和 Cox 时间依赖回归模型进行多变量分析,协变量为记录的自事件通知以来的天数。

结果

观察到 80 岁及以上(HR = 8.06;p < 0.001)、男性(HR = 1.45,p < 0.001)、非白色肤色(HR = 1.13;p < 0.033)或无信息(HR = 1.29;p < 0.001)、有合并症(HR = 10.44;p < 0.001)或未报告合并症的个体死亡风险最高。

结论

COVID-19 死亡的最高风险发生在老年人中,尤其是 80 岁以上的患者、有合并症的患者、男性和非白色肤色的患者。从识别健康系统识别的高死亡风险患者的特征,必须采取特定的医疗保健策略来预防这些病例向死亡的进展。

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