Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan.
Department of General and Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, Jordan.
J Infect Public Health. 2021 Jun;14(6):689-695. doi: 10.1016/j.jiph.2021.02.010. Epub 2021 Mar 6.
The number of COVID-19 infected patients has been soaring in the Middle East countries. The disease poses a significant threat, decisions about prioritizing care should be made in accordance with the proven risk factors for complications.
The present study provides the first bespoke prediction model in the Middle East to identify COVID-19 patients, who are at higher risk for complications.
A case-control study design was adopted to compare the characteristics of successfully recovered patients with those who had complications. Complications were defined as admission to the intensive care unit, mechanical ventilation, sepsis or septic shock, pneumonia or respiratory failure, and death. The prediction model was created through multivariable logistic regression. Overall statistical significance tests for the model were carried out.
All COVID-19 infected hospitalized patients (n = 133) in Amman - Jordan were included in the study. Successfully recovered were 125 patients. The median age (IRQ) was 26 (10-40). Almost 30% were >40 years. Patients with complications were eight patients, age 63 (51.5-71.5). The prediction model identified the following variables as risk factors: diabetes (OR = 59.7; 95% CI: 3.5-1011.5, p = 0.005), fever (OR = 24.8; 95% CI: 1.4-447.3, p = 0.029), SHORTNESS OF BREATH (OR = 15.9; 95% CI: 1.3-189.7, p = 0.029), body mass index (OR = 0.74; 95% CI: 0.61-0.88, p = 0.001), abnormal Neutrophils (OR = 16.8; 95% CI: 1.0-292.0, p = 0.053). Prediction model was statistically significant, χ(5) = 86.1, p < 0.0005.
Unlike reports from China, the most influential variables that led to disease progression in Jordanian patients were diabetes, fever, shortness of breath, body mass index, and abnormal neutrophils. Similar to reports from the USA, smoking was not a leading factor for complications. Comorbidities and patient health status, rather than age, were the primary risk factors for complications. Treatment with Hydroxychloroquine showed no protective effect.
中东国家的 COVID-19 感染患者数量一直在飙升。该疾病构成重大威胁,因此应根据并发症的明确风险因素来做出优先治疗决策。
本研究提供了中东地区首个定制预测模型,用于识别 COVID-19 患者,这些患者更容易发生并发症。
采用病例对照研究设计,比较成功康复患者与发生并发症患者的特征。并发症定义为入住重症监护病房、机械通气、脓毒症或感染性休克、肺炎或呼吸衰竭以及死亡。通过多变量逻辑回归建立预测模型。对模型进行了总体统计学显著性检验。
研究纳入了在约旦安曼的所有 COVID-19 住院感染患者(n = 133)。成功康复的患者有 125 名。中位年龄(IRQ)为 26(10-40)岁。近 30%的患者年龄大于 40 岁。有并发症的患者有 8 名,年龄为 63(51.5-71.5)岁。预测模型确定了以下变量为危险因素:糖尿病(OR = 59.7;95%CI:3.5-1011.5,p = 0.005)、发热(OR = 24.8;95%CI:1.4-447.3,p = 0.029)、呼吸急促(OR = 15.9;95%CI:1.3-189.7,p = 0.029)、体重指数(OR = 0.74;95%CI:0.61-0.88,p = 0.001)、异常中性粒细胞(OR = 16.8;95%CI:1.0-292.0,p = 0.053)。预测模型具有统计学显著性,χ²(5)= 86.1,p < 0.0005。
与中国的报告不同,导致约旦患者疾病进展的最主要影响因素是糖尿病、发热、呼吸急促、体重指数和异常中性粒细胞。与美国的报告类似,吸烟不是导致并发症的主要因素。合并症和患者健康状况而非年龄是并发症的主要危险因素。羟氯喹治疗没有显示出保护作用。