Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Division of Health Science Research, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2021 Mar;96(3):601-618. doi: 10.1016/j.mayocp.2020.12.006. Epub 2020 Dec 26.
To report the Mayo Clinic experience with coronavirus disease 2019 (COVID-19) related to patient outcomes.
We conducted a retrospective chart review of patients with COVID-19 diagnosed between March 1, 2020, and July 31, 2020, at any of the Mayo Clinic sites. We abstracted pertinent comorbid conditions such as age, sex, body mass index, Charlson Comorbidity Index variables, and treatments received. Factors associated with hospitalization and mortality were assessed in univariate and multivariate models.
A total of 7891 patients with confirmed COVID-19 infection with research authorization on file received care across the Mayo Clinic sites during the study period. Of these, 7217 patients were adults 18 years or older who were analyzed further. A total of 897 (11.4%) patients required hospitalization, and 354 (4.9%) received care in the intensive care unit (ICU). All hospitalized patients were reviewed by a COVID-19 Treatment Review Panel, and 77.5% (695 of 897) of inpatients received a COVID-19-directed therapy. Overall mortality was 1.2% (94 of 7891), with 7.1% (64 of 897) mortality in hospitalized patients and 11.3% (40 of 354) in patients requiring ICU care.
Mayo Clinic outcomes of patients with COVID-19 infection in the ICU, hospital, and community compare favorably with those reported nationally. This likely reflects the impact of interprofessional multidisciplinary team evaluation, effective leveraging of clinical trials and available treatments, deployment of remote monitoring tools, and maintenance of adequate operating capacity to not require surge adjustments. These best practices can help guide other health care systems with the continuing response to the COVID-19 pandemic.
报告梅奥诊所与新冠肺炎(COVID-19)患者结局相关的经验。
我们对 2020 年 3 月 1 日至 2020 年 7 月 31 日期间在梅奥诊所任何一个地点确诊的 COVID-19 患者进行了回顾性图表审查。我们提取了年龄、性别、体重指数、Charlson 合并症指数变量和接受的治疗等相关合并症。在单变量和多变量模型中评估了与住院和死亡率相关的因素。
在研究期间,共有 7891 例有文件记录的 COVID-19 感染患者在梅奥诊所接受了治疗。其中,7217 例是年龄在 18 岁或以上的成年人,进一步进行了分析。共有 897 例(11.4%)患者需要住院治疗,354 例(4.9%)患者在重症监护病房(ICU)接受治疗。所有住院患者都由 COVID-19 治疗审查小组进行了审查,77.5%(695/897)的住院患者接受了 COVID-19 定向治疗。总体死亡率为 1.2%(7891 例中的 94 例),住院患者死亡率为 7.1%(64/897),需要 ICU 护理的患者死亡率为 11.3%(40/354)。
梅奥诊所 COVID-19 感染患者在 ICU、医院和社区的结局与全国报告的结果相比表现良好。这可能反映了多学科团队评估、有效利用临床试验和现有治疗方法、远程监测工具的部署以及维持足够的运营能力以避免激增调整的影响。这些最佳实践可以帮助指导其他医疗保健系统应对 COVID-19 大流行的持续反应。