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武汉临时军用医院住院患者 COVID-19 症状的疾病负担:一项回顾性多中心横断面研究。

Disease burden from COVID-19 symptoms among inpatients at the temporary military hospitals in Wuhan: a retrospective multicentre cross-sectional study.

机构信息

Department of National Defense Education and Research, Fuzhou University, Fuzhou, China.

Department of Disease Control and Prevention, The No. 900 Hospital of Joint Logistics Support Troop of PLA, Fuzhou, China.

出版信息

BMJ Open. 2021 May 18;11(5):e048822. doi: 10.1136/bmjopen-2021-048822.

Abstract

OBJECTIVES

We aimed to establish a set of disability weights (DWs) for COVID-19 symptoms, evaluate the disease burden of inpatients and analyse the characteristics and influencing factors of the disease.

DESIGN

This was a multicentre retrospective cross-sectional descriptive study.

SETTING

The medical records generated in three temporary military hospitals in Wuhan.

PARTICIPANTS

Medical records of 2702 inpatients generated from 5 February to 5 April 2020 were randomly selected for this study.

PRIMARY AND SECONDARY OUTCOME MEASURES

DWs of COVID-19 symptoms were determined by the person trade-off approach. The inpatients' medical records were analysed and used to calculate the disability-adjusted life years (DALYs). The mean DALY was evaluated across sex and age groups. The relationship between DALY and age, sex, body mass index, length of hospital stay, symptom duration before admission and native place was determined by multiple linear regression.

RESULTS

For the DALY of each inpatient, severe expiratory dyspnoea, mild cough and sore throat had the highest (0.399) and lowest (0.004) weights, respectively. The average synthetic DALY and daily DALY were 2.29±1.33 and 0.18±0.15 days, respectively. Fever and fatigue contributed the most DALY at 31.36%, whereas nausea and vomiting and anxiety and depression contributed the least at 7.05%. There were significant differences between sex and age groups in both synthetic and daily DALY. Age, body mass index, length of hospital stay and symptom duration before admission were strongly related to both synthetic and daily DALY.

CONCLUSIONS

Although the disease burden was higher among women than men, their daily disease burdens were similar. The disease burden in the younger population was higher than that in the older population. Treatment at the hospitals relieved the disease burden efficiently, while a delay in hospitalisation worsened it.

摘要

目的

我们旨在建立一套 COVID-19 症状的失能权重(DWs),评估住院患者的疾病负担,并分析疾病的特征和影响因素。

设计

这是一项多中心回顾性横断面描述性研究。

设置

在武汉的三家临时军事医院生成的病历。

参与者

本研究随机选取了 2020 年 2 月 5 日至 4 月 5 日期间生成的 2702 名住院患者的病历。

主要和次要结果测量

通过权衡法确定 COVID-19 症状的 DWs。分析住院患者的病历并计算伤残调整生命年(DALYs)。评估不同性别和年龄组的平均 DALY。通过多元线性回归确定 DALY 与年龄、性别、体重指数、住院时间、入院前症状持续时间和籍贯之间的关系。

结果

对于每位住院患者的 DALY,严重呼气困难、轻度咳嗽和喉咙痛的权重最高(0.399),最低(0.004)。平均综合 DALY 和每日 DALY 分别为 2.29±1.33 天和 0.18±0.15 天。发热和疲劳导致的 DALY 最多,占 31.36%,而恶心和呕吐以及焦虑和抑郁导致的 DALY 最少,占 7.05%。综合 DALY 和每日 DALY 在性别和年龄组之间存在显著差异。年龄、体重指数、住院时间和入院前症状持续时间与综合和每日 DALY 均密切相关。

结论

尽管女性的疾病负担高于男性,但她们的日常疾病负担相似。年轻人群的疾病负担高于老年人群。医院治疗有效地减轻了疾病负担,而住院时间的延迟则加重了疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/785a/8130755/a5a086f733b6/bmjopen-2021-048822f01.jpg

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