Suzuki Ayako, Efird Jimmy T, Redding Thomas S, Thompson Andrew D, Press Ashlyn M, Williams Christina D, Hostler Christopher J, Hunt Christine M
Division of Gastroenterology, Duke University, Durham, NC 27710, USA.
Division of Gastroenterology, Durham VA Medical Center, Durham, NC 27705, USA.
Int J Environ Res Public Health. 2021 Aug 11;18(16):8486. doi: 10.3390/ijerph18168486.
We performed an observational Veterans Health Administration cohort analysis to assess how risk factors affect 30-day mortality in SARS-CoV-2-infected subjects relative to those uninfected. While the risk factors for coronavirus disease 2019 (COVID-19) have been extensively studied, these have been seldom compared with uninfected referents.
We analyzed 341,166 White/Black male veterans tested for SARS-CoV-2 from March 1 to September 10, 2020. The relative risk of 30-day mortality was computed for age, race, ethnicity, BMI, smoking status, and alcohol use disorder in infected and uninfected subjects separately. The difference in relative risk was then evaluated between infected and uninfected subjects. All the analyses were performed considering clinical confounders.
In this cohort, 7% were SARS-CoV-2-positive. Age >60 and overweight/obesity were associated with a dose-related increased mortality risk among infected patients relative to those uninfected. In contrast, relative to never smoking, current smoking was associated with a decreased mortality among infected and an increased mortality in uninfected, yielding a reduced mortality risk among infected relative to uninfected. Alcohol use disorder was also associated with decreased mortality risk in infected relative to the uninfected.
Age, BMI, smoking, and alcohol use disorder affect 30-day mortality in SARS-CoV-2-infected subjects differently from uninfected referents. Advanced age and overweight/obesity were associated with increased mortality risk among infected men, while current smoking and alcohol use disorder were associated with lower mortality risk among infected men, when compared with those uninfected.
我们进行了一项退伍军人健康管理队列观察性分析，以评估风险因素如何影响感染严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的受试者相对于未感染者的30天死亡率。虽然对2019冠状病毒病（COVID-19）的风险因素进行了广泛研究，但很少将这些因素与未感染的对照者进行比较。
我们分析了2020年3月1日至9月10日期间接受SARS-CoV-2检测的341,166名白种人/黑种人男性退伍军人。分别计算感染和未感染受试者在年龄、种族、民族、体重指数、吸烟状况和酒精使用障碍方面30天死亡率的相对风险。然后评估感染和未感染受试者之间相对风险的差异。所有分析均考虑了临床混杂因素。
在该队列中，7%的人SARS-CoV-2呈阳性。相对于未感染者，年龄>60岁以及超重/肥胖与感染患者中与剂量相关的死亡风险增加有关。相比之下，相对于从不吸烟，当前吸烟与感染患者死亡率降低以及未感染患者死亡率增加有关，从而使感染患者相对于未感染患者的死亡风险降低。酒精使用障碍也与感染患者相对于未感染患者的死亡风险降低有关。
年龄、体重指数、吸烟和酒精使用障碍对感染SARS-CoV-2的受试者30天死亡率的影响与未感染的对照者不同。与未感染者相比，高龄和超重/肥胖与感染男性的死亡风险增加有关，而当前吸烟和酒精使用障碍与感染男性的死亡风险降低有关。
