Alicante Institute of Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain.
Internal Medicine Department, Sant Vicent del Raspeig Hospital, San Vicente del Raspeig, 03690 Alicante, Spain.
Medicina (Kaunas). 2022 Apr 21;58(5):566. doi: 10.3390/medicina58050566.
. The aim of this study is to compare clinical and epidemiological characteristics and outcomes in patients with versus without nosocomial COVID-19 after exposure to SARS-CoV-2 and to analyze the risk factors for severe outcomes of COVID-19 in a long-term hospital in Spain. . This retrospective, single-center observational study included all inpatients in a long-term hospital during a COVID-19 outbreak from 21 January to 15 March 2021. . Of 108 admitted patients, 65 (60.2%) were diagnosed with nosocomial COVID-19 disease ( = 34 women (52.3%), median age 77 years). In the univariable analysis, risk factors associated with nosocomial COVID-19 were dementia (OR 4.98 95% CI 1.58-15.75), dyspnea (OR 5.34 95% CI 1.69-16.82), asthenia (OR 5.10, 95% CI 1.40-18.60) and NECesidades PALiativas (NECPAL) (OR 1.28 95% CI 1.10-1.48). In the multivariable analysis, risk factors independently associated with nosocomial COVID-19 infection were dyspnea (aOR 7.39; 95% CI 1.27-43.11) and NECPAL (aOR 1.25; 95% CI 1.03-1.52). Of the 65 patients diagnosed with nosocomial COVID-19, 29 (44.6%) died, compared to 7/43 (16.2%) non-infected patients (OR 4.14, 95% CI 1.61-10.67). Factors associated with mortality in nosocomial COVID-19 were confusion (aOR 3.83; 95% CI 1.03-14.27) and dyspnea (aOR 7.47; 95% CI 1.87-29.82). The NECPAL tool played an important predictive role in both nosocomial COVID-19 infection and mortality (aOR 1.19, 95% CI: 1.00-1.41). . In a long-term hospital, nosocomial COVID-19 main clinical characteristics associated with infection were dyspnea and NECPAL. Mortality was higher in the group with nosocomial COVID-19; risk factors were confusion and dyspnea. The NECPAL tool may help to predict progression and death in COVID-19.
. 本研究旨在比较 SARS-CoV-2 暴露后院内 COVID-19 患者与非 COVID-19 患者的临床和流行病学特征及结局，并分析西班牙一家长期医院 COVID-19 严重结局的危险因素。. 这是一项回顾性、单中心观察性研究，纳入了 2021 年 1 月 21 日至 3 月 15 日 COVID-19 爆发期间一家长期医院的所有住院患者。. 在 108 名住院患者中，65 名（60.2%）被诊断为院内 COVID-19 疾病（=34 名女性（52.3%），中位年龄 77 岁）。单因素分析显示，与院内 COVID-19 相关的危险因素为痴呆（OR 4.98，95%CI 1.58-15.75）、呼吸困难（OR 5.34，95%CI 1.69-16.82）、乏力（OR 5.10，95%CI 1.40-18.60）和 NECesidades PALiativas（NECPAL）（OR 1.28，95%CI 1.10-1.48）。多因素分析显示，与院内 COVID-19 感染相关的独立危险因素为呼吸困难（调整比值比[aOR]7.39；95%CI 1.27-43.11）和 NECPAL（aOR 1.25；95%CI 1.03-1.52）。在诊断为院内 COVID-19 的 65 名患者中，29 名（44.6%）死亡，而未感染的 43 名患者中仅 7 名（16.2%）死亡（OR 4.14，95%CI 1.61-10.67）。院内 COVID-19 患者死亡的相关因素为意识混乱（aOR 3.83；95%CI 1.03-14.27）和呼吸困难（aOR 7.47；95%CI 1.87-29.82）。NECPAL 工具在院内 COVID-19 感染和死亡率方面均发挥了重要的预测作用（调整比值比[aOR]1.19，95%CI：1.00-1.41）。. 在一家长期医院中，与院内 COVID-19 感染相关的主要临床特征为呼吸困难和 NECPAL。院内 COVID-19 组死亡率较高；危险因素为意识混乱和呼吸困难。NECPAL 工具可能有助于预测 COVID-19 患者的病情进展和死亡。
