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在大流行的第二波期间,住院 COVID-19 患者的临床特征、结局和死亡率的变化:单中心经验。

Variation in clinical characteristics, outcomes, and mortality of hospitalized patients with COVID-19 during the second wave of the pandemic: a single-center experience.

机构信息

Department of Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA

Department of Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.

出版信息

J Investig Med. 2021 Dec;69(8):1479-1482. doi: 10.1136/jim-2021-001876. Epub 2021 Sep 13.

Abstract

As of February 2, 2021, the USA has 26,431,799 reported COVID-19 cases with 446,744 deaths. A high mortality rate (15%-40%) was reported among hospitalized patients with COVID-19 during the first wave of the pandemic. However, data regarding variation in COVID-19-related mortality and severity of illness among hospitalized patients with COVID-19 are heterogeneous. In this retrospective single-center study, we aimed to investigate the demographic characteristics, clinical presentations, disease severity, clinical outcomes, and in-hospital mortality of hospitalized patients with COVID-19 during the second wave of the pandemic. Adults with reverse transcription-PCR-confirmed SARS-CoV-2 infection were included. In-hospital mortality due to COVID-19 was the primary outcome, and intensive care unit admission, acute kidney injury, acute respiratory distress syndrome, respiratory failure requiring intubation, and septic shock were the secondary outcomes. A total of 101 adult patients were hospitalized with COVID-19 during the second wave study period. Of 101 patients, 8 were intubated and 6 died. The median duration of hospital stay was 6 days. Patients in the second wave were more likely to receive dexamethasone and remdesivir and less likely to require invasive mechanical ventilation. In-hospital mortality during the second wave was lower (5.9%) compared with the first wave (15.5%). At the last follow-up date, 86.1% were discharged alive from the hospital, 5.9% died and 7.9% were still in the hospital. Multivariate logistic regression showed higher odds of mortality were associated with higher age and elevated lactate dehydrogenase peak.

摘要

截至 2021 年 2 月 2 日,美国报告了 26431799 例 COVID-19 病例,其中 446744 人死亡。在大流行的第一波期间,住院的 COVID-19 患者的死亡率(15%-40%)较高。然而,关于住院 COVID-19 患者与 COVID-19 相关的死亡率和疾病严重程度的变化的数据存在差异。在这项回顾性单中心研究中,我们旨在研究大流行第二波期间住院 COVID-19 患者的人口统计学特征、临床表现、疾病严重程度、临床结局和住院死亡率。包括经逆转录聚合酶链反应确认的 SARS-CoV-2 感染的成年人。COVID-19 导致的住院死亡率是主要结局,入住重症监护病房、急性肾损伤、急性呼吸窘迫综合征、需要插管的呼吸衰竭和感染性休克是次要结局。在第二波研究期间,共有 101 名成年患者因 COVID-19 住院。在 101 名患者中,有 8 名需要插管,有 6 名死亡。住院时间中位数为 6 天。第二波患者更有可能接受地塞米松和瑞德西韦治疗,而不太可能需要有创机械通气。与第一波(15.5%)相比,第二波的住院死亡率较低(5.9%)。在最后一次随访日期,86.1%的患者从医院活着出院,5.9%的患者死亡,7.9%的患者仍在住院。多变量逻辑回归显示,死亡率较高与较高的年龄和升高的乳酸脱氢酶峰值相关。

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