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与新冠病毒感染患者生存相关的预后因素:对214例伊朗患者的回顾性研究

Prognostic Factors Associated with Survival in Patients Infected with COVID-19: A Retrospective Study on 214 Patients from Iran.

作者信息

Sadeghi Amir, Eslami Pegah, Dooghaie Moghadam Arash, Moazzami Bobak, Pirsalehi Ali, Ilkhani Saba, Banar Sepideh, Feizollahi Fateme, Vahidi Mohammad, Abdi Saeed, Asadzadeh Aghdaei Hamid, Zali Mohammad Reza, Nasserinejad Maryam

机构信息

Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Iran Med. 2021 Apr 1;24(4):333-338. doi: 10.34172/aim.2021.47.

Abstract

BACKGROUND

Decision-making on allocating scarce medical resources is crucial in the context of a strong health system reaction to the coronavirus disease 2019 (COVID-19) pandemic. Therefore, understanding the risk factors related to a high mortality rate can enable the physicians for a better decision-making process.

METHODS

Information was collected regarding clinical, demographic, and epidemiological features of the definite COVID-19 cases. Through Cox regression and statistical analysis, the risk factors related to mortality were determined. The Kaplan-Meier curve was used to estimate survival function and measure the mean length of living time in the patients.

RESULTS

Among about 3000 patients admitted in the Taleghani hospital as outpatients with suspicious signs and symptoms of COVID-19 in 2 months, 214 people were confirmed positive for this virus using the polymerase chain reaction (PCR) technique. Median time to death was 30 days. In this population, 24.29% of the patients died and 24.76% of them were admitted to the ICU (intensive care unit) during hospitalization. The results of Multivariate Cox regression Analysis showed that factors including age (HR, 1.031; 95% CI, 1.001-1.062; value=0.04), and C-reactive protein (CRP) (HR, 1.007; 95% CI, 1.000-1.015; value=0.04) could independently predict mortality. Furthermore, the results showed that age above 59 years directly increased mortality rate and decreased survival among our study population.

CONCLUSION

Predictor factors play an important role in decisions on public health policy-making. Our findings suggested that advanced age and CRP were independent mortality rate predictors in the admitted patients.

摘要

背景

在卫生系统对2019冠状病毒病(COVID-19)大流行做出强烈反应的背景下,分配稀缺医疗资源的决策至关重要。因此,了解与高死亡率相关的风险因素能够使医生进行更好的决策过程。

方法

收集了确诊COVID-19病例的临床、人口统计学和流行病学特征信息。通过Cox回归和统计分析,确定了与死亡率相关的风险因素。采用Kaplan-Meier曲线估计生存函数并测量患者的平均生存时间。

结果

在2个月内,约3000名因COVID-19可疑体征和症状作为门诊患者入住塔莱哈尼医院的患者中,214人使用聚合酶链反应(PCR)技术确诊感染该病毒。中位死亡时间为30天。在该人群中,24.29%的患者死亡,24.76%的患者在住院期间被收入重症监护病房(ICU)。多变量Cox回归分析结果显示,年龄(HR,1.031;95%CI,1.001 - 1.062;P值 = 0.04)和C反应蛋白(CRP)(HR,1.007;95%CI,1.000 - 1.015;P值 = 0.04)等因素可独立预测死亡率。此外,结果表明,59岁以上的年龄直接增加了我们研究人群的死亡率并降低了生存率。

结论

预测因素在公共卫生政策制定决策中发挥着重要作用。我们的研究结果表明,高龄和CRP是入院患者死亡率的独立预测因素。

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