2019年冠状病毒病年轻成人患者的院内30天生存率：一项队列研究
In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study.
作者信息
Richardson Safiya, Gitlin Jordan, Kozel Zachary, Levy Sera, Rahman Husneara, Hirsch Jamie S, McGinn Thomas, Diefenbach Michael A
机构信息
Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA.
出版信息
Open Forum Infect Dis. 2021 May 7;8(6):ofab233. doi: 10.1093/ofid/ofab233. eCollection 2021 Jun.
BACKGROUND
Our objective was to characterize young adult patients hospitalized with coronavirus disease 2019 (COVID-19) and identify predictors of survival at 30 days.
METHODS
This retrospective cohort study took place at 12 acute care hospitals in the New York City area. Patients aged 18-39 hospitalized with confirmed COVID-19 between March 1 and April 27, 2020 were included in the study. Demographic, clinical, and outcome data were extracted from electronic health record reports.
RESULTS
A total of 1013 patients were included in the study (median age, 33 years; interquartile range [IQR], 28-36; 52% female). At the study end point, 940 (92.8%) patients were discharged alive, 18 (1.8%) remained hospitalized, 5 (0.5%) were transferred to another acute care facility, and 50 (4.9%) died. The most common comorbidities in hospitalized young adult patients were obesity (51.2%), diabetes mellitus (14.8%), and hypertension (13%). Multivariable analysis revealed that obesity (adjusted hazard ratio [aHR], 2.71; 95% confidence interval [CI], 1.28-5.73; = .002) and Charlson comorbidity index score (aHR, 1.20; 95% CI, 1.07-1.35; = .002) were independent predictors of in-hospital 30-day mortality.
CONCLUSIONS
Obesity was identified as the strongest negative predictor of 30-day in-hospital survival in young adults with COVID-19.
背景
我们的目标是对2019冠状病毒病（COVID-19）住院的年轻成年患者进行特征描述，并确定30天生存率的预测因素。
方法
这项回顾性队列研究在纽约市地区的12家急症医院进行。纳入2020年3月1日至4月27日期间确诊为COVID-19住院的18至39岁患者。从电子健康记录报告中提取人口统计学、临床和结局数据。
结果
共1013例患者纳入研究（中位年龄33岁；四分位间距[IQR]为28 - 36岁；52%为女性）。在研究终点，940例（92.8%）患者存活出院，18例（1.8%）仍住院，5例（0.5%）转至另一家急症医疗机构，50例（4.9%）死亡。住院年轻成年患者最常见的合并症为肥胖（51.2%）、糖尿病（14.8%）和高血压（13%）。多变量分析显示，肥胖（校正风险比[aHR]为2.71；95%置信区间[CI]为1.28 - 5.73；P = 0.002）和查尔森合并症指数评分（aHR为1.20；95% CI为1.07 - 1.35；P = 0.002）是院内30天死亡率的独立预测因素。
结论
肥胖被确定为COVID-19年轻成年患者30天院内生存率最强的负性预测因素。
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