Vergara Pasquale, Rossi Luca, Biagi Andrea, Falasconi Giulio, Pannone Luigi, Zanni Alessia, Sticozzi Concetta, Comastri Greta, Gandolfi Stefano, Godino Cosmo, Malagoli Alessandro, Villani Giovanni Q
Arrhythmia Unit and Electrophysiology Laboratories, Department of Cardiology and Cardiothoracic Surgery, IRCCS San Raffaele Hospital, Milan, Italy -
Division of Cardiology, Department Cardiovascular and Emergency, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Minerva Med. 2023 Apr;114(2):185-190. doi: 10.23736/S0026-4806.21.07187-1. Epub 2021 Apr 29.
Cardiovascular comorbidities are a common cause of death in COVID-19 and the aim of this study is to evaluate the effect of comorbidities on mortality in COVID-19 patients.
In this retrospective observational study we enrolled 1049 patients hospitalized with confirmed SARS-CoV-2 infection in a single Italian Center from 21 February to 20 March 2020 Evaluated risk factors (RFs) were: advanced age, gender, hypertension, diabetes, atrial fibrillation, hyperlipidemia, chronic kidney disease, thyroid disease, chronic obstructive pulmonary disease, malignancy, stroke, cardiovascular disease, and peripheral vascular disease. Endpoint of the study was death from any cause. A multivariate logistic regression model was built using covariates that showed as statistically significant at univariate regression analysis.
Median age at presentation was 71.1 years (IQR: 59.1-80.5); 244 (72.2%) were males. Primary outcome occurred in 338 patients (32.2%). In decedents, median survival from Hospitalization was 6 (IQR: 3-10) days. 264 decedents had 1 RF, 120 had 2 RFs and 39 had ≥3 RFs. At multivariate logistic regression model, variables associated with primary outcome were: age class (64-69 years) (OR 3.03, CI: 1.75-5.31, P<0.001), age class (70-88 years) (OR 10.08, CI: 6.67-15.72, P<0.001), age class (≥88 years) (OR 23.99, CI: 13.21-44.82, P<0.001), male gender (OR 1.88, CI: 1.36-2.62, P<0.001), diabetes (OR 1.56, CI: 1.07-2.26, P=0.02), stroke (OR 3.41, CI: 1.33-9.91, P=0.015).
Age, male gender, presence of diabetes and stroke appeared as independent predictors of mortality in COVID-19 patients. A table for risk of 30 days-mortality in SARS-CoV-2 infection was built, based on odds ratios derived from multivariate regression analysis.
心血管合并症是新冠病毒病(COVID-19)常见的死亡原因,本研究旨在评估合并症对COVID-19患者死亡率的影响。
在这项回顾性观察研究中,我们纳入了2020年2月21日至3月20日期间在意大利一家中心确诊感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)并住院的1049例患者。评估的危险因素包括:高龄、性别、高血压、糖尿病、心房颤动、高脂血症、慢性肾脏病、甲状腺疾病、慢性阻塞性肺疾病、恶性肿瘤、中风、心血管疾病和外周血管疾病。研究终点为任何原因导致的死亡。使用在单变量回归分析中显示具有统计学意义的协变量建立多变量逻辑回归模型。
就诊时的中位年龄为71.1岁(四分位间距:59.1 - 80.5);244例(72.2%)为男性。338例患者(32.2%)出现主要结局。在死亡患者中,住院后的中位生存期为6天(四分位间距:3 - 10)。264例死亡患者有1种危险因素,120例有2种危险因素,39例有≥3种危险因素。在多变量逻辑回归模型中,与主要结局相关的变量有:年龄组(64 - 69岁)(比值比3.03,置信区间:1.75 - 5.31,P<0.001),年龄组(70 - 88岁)(比值比10.08,置信区间:6.67 - 15.72,P<0.001),年龄组(≥88岁)(比值比23.99,置信区间:13.21 - 44.82,P<0.001),男性(比值比1.88,置信区间:1.36 - 2.62,P<0.001),糖尿病(比值比1.56,置信区间:1.07 - 2.26,P = 0.02),中风(比值比3.41,置信区间:1.33 - 9.91,P = 0.015)。
年龄、男性、糖尿病和中风的存在似乎是COVID-19患者死亡率的独立预测因素。基于多变量回归分析得出的比值比,建立了SARS-CoV-2感染30天死亡率风险表。