Abu Dhabi Healthcare Services, 81815, Alain, United Arab Emirates.
UAEU, Community Medicine Department, Alain, United Arab Emirates.
J Epidemiol Glob Health. 2021 Dec;11(4):344-353. doi: 10.1007/s44197-021-00006-4. Epub 2021 Aug 23.
Prediction models are essential for informing screening, assessing prognosis, and examining options for treatment. This study aimed to assess the risk of SARS-CoV-2 infection severity in the Abu Dhabi population.
This is a mixed retrospective cohort study and case-control study to explore the associated factors of receiving treatment in the community, being hospitalized, or requiring complex hospital care among patients with a diagnosis of SARS-CoV-2. Of 641 patients included, 266 were hospitalized; 135 were hospitalized and either died or required complex care, i.e., required ICU admission, intubation, or oxygen and 131 did not develop severe disease requiring complex care. The third group ("controls") were 375 patients who were not hospitalized. Logistic regression analyses were used to study predictors of disease severity.
Among hospitalized patients older age and low oxygen saturation at admission were the consistent and strongest predictors of an adverse outcome. Risk factors for the death in addition to age and low oxygen saturation were elevated white blood count and low reported physical activity. Chronic kidney disease and diabetes were also associated with more severe disease in logistic regression. The mortality rate among those with less than 30 min per week of physical activity was 4.9%, while the mortality rate was 0.35% for those with physical activity > 30 min at least once a week. The interval from the onset of symptoms to admission and mortality was found to have a significant inverse relationship, with worse survival for shorter intervals.
Oxygen saturation is an important measure that should be introduced at screening sites and used in the risk assessment of patients with SARS-CoV-2. In addition, an older age was a consistent factor in all adverse outcomes, and other factors, such as low physical activity, elevated WBC, CKD, and DM, were also identified as risk factors.
预测模型对于告知筛查、评估预后以及检查治疗方案至关重要。本研究旨在评估阿布扎比人群感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的风险。
本研究是一项混合回顾性队列研究和病例对照研究,旨在探索社区治疗、住院治疗或需要复杂医院护理的 SARS-CoV-2 患者的相关因素。641 例患者中,266 例住院,其中 135 例住院死亡或需要复杂护理,即需要入住重症监护病房、插管或吸氧,131 例未发生需要复杂护理的严重疾病。第三组(“对照组”)为 375 例未住院患者。使用逻辑回归分析研究疾病严重程度的预测因素。
在住院患者中,年龄较大和入院时低氧饱和度是不良结局的一致且最强预测因素。除年龄和低氧饱和度外,白细胞计数升高和低体力活动报告也是死亡的危险因素。慢性肾脏病和糖尿病在逻辑回归中也与更严重的疾病相关。每周体力活动少于 30 分钟的患者死亡率为 4.9%,而每周至少一次体力活动超过 30 分钟的患者死亡率为 0.35%。从症状出现到入院和死亡的时间间隔与死亡率呈显著负相关,间隔时间越短,生存情况越差。
氧饱和度是一项重要的指标,应在筛查点引入,并用于 SARS-CoV-2 患者的风险评估。此外,年龄较大是所有不良结局的一致因素,其他因素,如低体力活动、白细胞计数升高、慢性肾脏病和糖尿病,也被确定为危险因素。