Research Programme on Biomedical Informatics, Hospital del Mar Medical Research Institute, Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, Sant Fruitós de Bages, Spain.
JMIR Public Health Surveill. 2021 Feb 8;7(2):e25452. doi: 10.2196/25452.
The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic.
The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19.
An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain.
The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17% of the patients were aged ≥60 years. 175,484/348,596 patients (50.34%) were women. A total of 23,844/348,596 patients (6.84%) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1%) and obesity (5181 patients, 21.7%). Overall, 2680/348,596 patients in the study population (0.77%) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56%; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58%; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95% CI 6.06-7.15).
We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2.
西班牙是 COVID-19 发病率最高的国家之一，截至 2020 年 10 月底，累计确诊病例超过 100 万例。患有慢性疾病、肥胖症和癌症的患者感染 COVID-19 的风险更高；此外，自大流行开始以来，人们越来越关注血管紧张素转换酶抑制剂（ACEIs）和血管紧张素 II 受体阻滞剂（ARBs）的使用及其与 COVID-19 易感性的关系。
本研究的目的是比较初级保健中确诊 COVID-19 患者与未确诊 COVID-19 患者的特征；确定与死亡率相关的危险因素；并确定 ACEIs 和 ARBs 等某些药物对 COVID-19 患者死亡率的潜在影响。
对 2020 年 3 月 1 日至 8 月 17 日期间在西班牙加泰罗尼亚中部地区确诊 COVID-19 的患者进行了一项观察性回顾性研究。数据来自西班牙巴塞罗那加泰罗尼亚卫生研究所的初级保健服务信息技术系统。
研究人群包括 348596 名（年龄>15 岁）在加泰罗尼亚中部地区初级保健服务信息技术系统登记的患者。患者的平均年龄为 49.53 岁（标准差 19.42），31.17%的患者年龄≥60 岁。175484/348596 名（50.34%）患者为女性。在研究期间，共有 23844/348596 名（6.84%）患者被诊断患有 COVID-19，这些患者最常见的临床病症是高血压（5267 例，22.1%）和肥胖症（5181 例，21.7%）。总的来说，在研究期间，348596 名患者中有 2680 名（0.77%）死亡。无 COVID-19 的患者中死亡人数为 1825/324752（0.56%；平均年龄 80.6 岁，标准差 13.3），而确诊 COVID-19 的患者中死亡人数为 855/23844（3.58%；平均年龄 83.0 岁，标准差 10.80），比值比为 6.58（95%置信区间 6.06-7.15）。
我们观察到女性比男性更容易感染 COVID-19。此外，我们的研究并未表明高血压、肥胖症或使用 ACEIs 或 ARBs 与 COVID-19 患者死亡率的增加有关。年龄是感染 SARS-CoV-2 的患者死亡的主要因素。
