Section of Infectious Diseases, Taipei City Hospital, Taipei 10341, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan.
Int J Environ Res Public Health. 2022 Mar 12;19(6):3357. doi: 10.3390/ijerph19063357.
The timing of death in patients with coronavirus disease 2019 (COVID-19) varied by their comorbidities and severity of illness. However, few studies have determined predictors of mortality with respect to the timing of death in infectious patients. This cohort study aimed to identify the factors associated with early and late death in hospitalized COVID-19 patients. From 14 May to 31 July 2021, this study consecutively recruited laboratory-confirmed COVID-19 patients admitted to Taipei City Hospital. All patients with COVID-19 were followed up until death or discharge from the hospital or till 13 August 2021. Mortality in such patients was categorized as early death (death within the first two weeks of hospitalization) or late death (mortality later than two weeks after hospitalization), based on the timing of death. Multinomial logistic regression was used to determine the factors associated with early and late death among such patients. Of 831 recruited patients, the overall mean age was 59.3 years, and 12.2% died during hospitalization. Of the 101 deceased, 66 (65.3%) and 35 (34.7%) died early and late, respectively. After adjusting for demographics and comorbidities, independent predictors for early death included age ≥ 65 years (adjusted odds ratio (AOR) = 5.27; 95% confidence interval (CI): 2.88-9.65), heart failure (AOR = 10.32; 95% CI: 2.28-46.65), and end-stage renal disease (AOR = 11.97; 95% CI: 3.53-40.55). This study found that two thirds of COVID-19 deaths occurred within two weeks of hospitalization. It suggests that hospitalized patients with COVID-19 should be treated carefully and monitored closely for the progression of clinical conditions during treatment, particularly in older patients and in those with comorbidities.
2019 年冠状病毒病（COVID-19）患者的死亡时间因合并症和疾病严重程度而异。然而，很少有研究确定与传染病患者死亡时间有关的死亡预测因素。本队列研究旨在确定与 COVID-19 住院患者早期和晚期死亡相关的因素。本研究于 2021 年 5 月 14 日至 7 月 31 日连续招募了台北市医院收治的实验室确诊的 COVID-19 患者。所有 COVID-19 患者均随访至死亡或出院或 2021 年 8 月 13 日。根据死亡时间，将此类患者的死亡率分为早期死亡（住院后两周内死亡）或晚期死亡（住院后两周后死亡）。采用多项逻辑回归确定此类患者早期和晚期死亡的相关因素。在 831 名入组患者中，总体平均年龄为 59.3 岁，住院期间有 12.2%的患者死亡。在 101 例死亡患者中，分别有 66 例（65.3%）和 35 例（34.7%）为早期和晚期死亡。在调整人口统计学和合并症后，早期死亡的独立预测因素包括年龄≥65 岁（调整优势比（AOR）=5.27；95%置信区间（CI）：2.88-9.65）、心力衰竭（AOR=10.32；95%CI：2.28-46.65）和终末期肾病（AOR=11.97；95%CI：3.53-40.55）。本研究发现，COVID-19 死亡中有三分之二发生在住院后两周内。这表明 COVID-19 住院患者在治疗期间应谨慎治疗，并密切监测病情进展，尤其是在老年患者和合并症患者中。
