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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.

DOI:10.1093/ofid/ofab233
PMID:34183983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8135976/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ff/8231375/49c5d6e7af47/ofab233f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ff/8231375/297ddf590cac/ofab233f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ff/8231375/49c5d6e7af47/ofab233f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ff/8231375/297ddf590cac/ofab233f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72ff/8231375/49c5d6e7af47/ofab233f0002.jpg

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