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美国住院的哮喘或慢性阻塞性肺疾病患者(无论是否合并 COVID-19)的临床结局。

Clinical outcomes among hospitalized US adults with asthma or chronic obstructive pulmonary disease, with or without COVID-19.

机构信息

Asthma and Community Health Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.

出版信息

J Asthma. 2022 Dec;59(12):2509-2519. doi: 10.1080/02770903.2021.2018703. Epub 2021 Dec 29.

Abstract

OBJECTIVE

This study assesses the risk of severe clinical outcomes during hospitalizations of adults with asthma and/or COPD plus COVID-19 and compares those risks with those during hospitalizations of adults with asthma and/or COPD without COVID-19.

METHODS

We used data from 877 U.S. hospitals from the Premier Healthcare Database during March 2020-March 2021. Hospitalizations ( = 311,215) among patients aged ≥18 years with an ICD-10-CM diagnosis involving asthma or COPD were classified into three groups: adults with asthma (but not COPD), adults with COPD (but not asthma), and adults with both asthma and COPD. We used multivariable Poisson regression to assess associations of severe clinical outcomes [intensive care unit (ICU) admission, use of invasive mechanical ventilation (IMV), and death] and COVID-19 status.

RESULTS

The percentage of hospitalizations among patients with asthma and COVID-19 resulting in ICU admission, IMV, and death were 46.9%, 14.0%, and 8.0%, respectively. These risks were higher than those among patients with asthma without COVID-19 (adjusted risk ratio [aRR], 1.17 [95% confidence interval (CI), 1.14-1.21], 1.61 [95% CI, 1.50-1.73], and 5.56 [95% CI, 4.89-6.32]), respectively. Risks of ICU admission, IMV, and death were also high among patients with COPD and COVID-19 and exceeded the corresponding risks among patients with COPD without COVID-19.

CONCLUSION

Hospitalizations among patients with asthma and/or COPD with COVID-19 had a more severe clinical course than hospitalizations for asthma and/or COPD exacerbations without COVID-19.

UNLABELLED

Supplemental data for this article is available online at at www.tandfonline.com/ijas .

摘要

目的

本研究评估了患有哮喘和/或 COPD 合并 COVID-19 的成年人住院期间发生严重临床结局的风险,并将这些风险与未感染 COVID-19 的哮喘和/或 COPD 成年人住院期间的风险进行比较。

方法

我们使用了 2020 年 3 月至 2021 年 3 月期间来自 Premier Healthcare Database 的 877 家美国医院的数据。将年龄≥18 岁的患者中涉及哮喘或 COPD 的 ICD-10-CM 诊断的住院治疗( = 311215)分为三组:单纯哮喘患者、单纯 COPD 患者和同时患有哮喘和 COPD 的患者。我们使用多变量泊松回归来评估严重临床结局(入住重症监护病房[ICU]、使用有创机械通气[IMV]和死亡)与 COVID-19 状态之间的关联。

结果

患有哮喘和 COVID-19 的患者中,因 ICU 入住、IMV 和死亡而住院的比例分别为 46.9%、14.0%和 8.0%。这些风险高于未感染 COVID-19 的哮喘患者(调整后的风险比[aRR],1.17[95%置信区间[CI],1.14-1.21]、1.61[95% CI,1.50-1.73]和 5.56[95% CI,4.89-6.32])。同时患有 COPD 和 COVID-19 的患者的 ICU 入住、IMV 和死亡风险也很高,超过了未感染 COVID-19 的 COPD 患者的相应风险。

结论

患有哮喘和/或 COPD 且合并 COVID-19 的患者的住院治疗比未合并 COVID-19 的哮喘和/或 COPD 加重患者的住院治疗有更严重的临床病程。

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