新冠病毒感染病例的特征和预后因素：一项全国性的突尼斯分析。
Characteristics and prognostic factors of COVID-19 among infected cases: a nationwide Tunisian analysis.
机构信息
Department of Epidemiology and Statistics, Abderrahman Mami Hospital, Ariana, Tunisia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
出版信息
BMC Infect Dis. 2021 Feb 3;21(1):140. doi: 10.1186/s12879-021-05844-y.
BACKGROUND
The outbreak of coronavirus disease (COVID-19) continues to constitute an international public health concern. Few data are available on the duration and prognostic factors of the disease. We aimed to study the recovery time among a Tunisian cohort of COVID-19 confirmed patients and identify the prognostic factors.
METHODS
A retrospective, nationwide study was conducted from March 2 to May 8, 2020, recruiting all patients who were diagnosed with COVID-19, by RT-PCR methods, in Tunisia. Data were collected via phone call interview. Kaplan-Meir Methods and Cox proportional hazards regression models were, respectively, used to study the recovery time and estimate its prognostic factors.
RESULTS
One thousand and thirty patients with COVID-19 (aged 43.2 ± 18.2 years, 526 female (51.1%)) were enrolled. Among them 141 (14.8%) were healthcare professionals. Out of 173 patients (17.8%) admitted to the hospital, 47 were admitted in an intensive care unit. Among 827 patients who didn't require specialized care, 55.5% were self-isolated at home, while the rest were in specialized centers. Six hundred and two patients were symptomatic. A total of 634 (61.6%) patients have recovered and 45 (4.4%) patients died. The median duration of illness was estimated to be 31 days (95% CI: [29-32]). Older age (HR = 0.66, CI:[0.46-0.96], P = 0.031) and symptoms (HR = 0.61, CI:[0.43-0.81], P = 0.021) were independently associated with a delay in recovery time. Being a healthcare professional (HR = 1.52, CI: [1.10-2.08], P = 0.011) and patients in home isolation compared to isolation centers (HR = 2.99, CI: [1.85-4.83], P < 10¯) were independently associated with faster recovery time.
CONCLUSION
The duration of illness was estimated to be 1 month. However, this long estimated duration of illness may not equate to infectiousness. A particular attention must to be paid to elderly and symptomatic patients with closer monitoring.
背景
冠状病毒病（COVID-19）的爆发继续构成国际公共卫生关注。关于该病的持续时间和预后因素的数据很少。我们旨在研究突尼斯队列中 COVID-19 确诊患者的恢复时间，并确定预后因素。
方法
这是一项回顾性的全国性研究，于 2020 年 3 月 2 日至 5 月 8 日进行，招募了所有在突尼斯通过 RT-PCR 方法诊断为 COVID-19 的患者。数据通过电话访谈收集。Kaplan-Meier 方法和 Cox 比例风险回归模型分别用于研究恢复时间并估计其预后因素。
结果
共纳入 1030 名 COVID-19 患者（年龄 43.2±18.2 岁，526 名女性（51.1%））。其中 141 名（14.8%）是医护人员。173 名（17.8%）住院患者中，47 名入住重症监护病房。在 827 名无需专科护理的患者中，55.5%在家中自我隔离，其余在专科中心。602 名患者有症状。共有 634 名（61.6%）患者康复，45 名（4.4%）患者死亡。估计疾病的中位持续时间为 31 天（95%CI：[29-32]）。年龄较大（HR=0.66，CI：[0.46-0.96]，P=0.031）和有症状（HR=0.61，CI：[0.43-0.81]，P=0.021）与恢复时间延迟独立相关。医护人员（HR=1.52，CI：[1.10-2.08]，P=0.011）和与隔离中心相比在家中隔离的患者（HR=2.99，CI：[1.85-4.83]，P<10¯）与更快的恢复时间独立相关。
结论
估计疾病的持续时间为 1 个月。然而，这种对疾病持续时间的长期估计并不等同于传染性。必须特别注意密切监测老年和有症状的患者。
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