埃塞俄比亚西北部南贡德尔地区新冠肺炎严重程度的生存时间及其预测因素：一项前瞻性队列研究
Survival Time to COVID-19 Severity and Its Predictors in South Gondar Zone, North-West Ethiopia: A Prospective Cohort Study.
作者信息
Yemata Getaneh Atikilt, Tesfaw Aragaw, Mihret Gashaw, Tiruneh Mulu, Walle Zebader, Molla Eshetie, Sisay Ermias, Admassu Fitalew Tadele, Habtie Eyaya, Desalagn Tsion, Shimels Habtamu, Teshome Fentaw
机构信息
Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia.
Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara Region, Ethiopia.
出版信息
J Multidiscip Healthc. 2022 May 23;15:1187-1201. doi: 10.2147/JMDH.S361061. eCollection 2022.
BACKGROUND
Coronavirus disease is still a global public health emergency. Due to an inadequate healthcare system in low-income nations like Ethiopia, the pandemic has had a devastating impact. Despite this, information on the severity of COVID-19 and related difficulties in Ethiopia is sparse. Therefore, we aimed to determine the survival time to severity and predictors of COVID-19 in Northwest Ethiopia.
METHODS
A prospective follow-up study was conducted among 202 adult COVID-19 patients in the South Gondar zone treatment centers. Data were entered using EpiData version 3.1 and then exported to Stata 16 for analysis. Kaplan-Meier was used to estimate mean survival time, and Log rank tests were used to compare survival time between explanatory variable groups. A cox-proportional hazards regression model with a 95% confidence interval and a p-value of 0.05 was used to identify covariates associated with the outcome variable.
RESULTS
The patients' average age was 41.2 years. With an IQR of 4-7 days, the median time to COVID-19 severity was 5 days. The overall COVID-19 severity rate was 6.35 (95% CI: 5.17-7.86) per 100 person-days observed. Senior adult age group (51-59 years) (AHR = 3.59, 95% CI: 1.05, 12.23), elderly age group (≥60 years) (AHR = 2.11, 95% CI: 1.09, 12.67), comorbidity (AHR = 3.26, 95% CI: 1.48, 7.18), high blood pressure at admission (AHR = 4.36, 95% CI: 1.99, 9.54), and high temperature at admission (AHR = 5.60, 95% CI: 2.55, 12.46) were significantly associated with COVID-19 severity time.
CONCLUSION AND RECOMMENDATION
Patients with COVID-19 had a short median severity time, and factors like older age, comorbidity, high temperature, and high blood pressure were all independent predictors of severity time. Patients with high body temperature, blood pressure, comorbidity, and advanced age should be the focus of interventions to reduce progression time and improve clinical outcomes.
背景
冠状病毒病仍是全球突发公共卫生事件。由于像埃塞俄比亚这样的低收入国家医疗体系不完善，这场大流行产生了毁灭性影响。尽管如此，关于埃塞俄比亚新冠肺炎严重程度及相关困难的信息却很匮乏。因此，我们旨在确定埃塞俄比亚西北部新冠肺炎严重程度的生存时间及预测因素。
方法
在南贡德尔地区治疗中心对202例成年新冠肺炎患者进行了一项前瞻性随访研究。数据使用EpiData 3.1版本录入，然后导出到Stata 16进行分析。采用Kaplan-Meier法估计平均生存时间，采用对数秩检验比较解释变量组之间的生存时间。使用具有95%置信区间和p值为0.05的Cox比例风险回归模型来识别与结果变量相关的协变量。
结果
患者的平均年龄为41.2岁。新冠肺炎严重程度的中位时间为5天，四分位距为4 - 7天。每100人日观察到的新冠肺炎总体严重率为6.35（95%置信区间：5.17 - 7.86）。老年年龄组（51 - 59岁）（调整后风险比 = 3.59，95%置信区间：1.05，12.23）、高龄年龄组（≥60岁）（调整后风险比 = 2.11，95%置信区间：1.09，12.67）、合并症（调整后风险比 = 3.26，95%置信区间：1.48，7.18）、入院时高血压（调整后风险比 = 4.36，95%置信区间：1.99，9.54）以及入院时高温（调整后风险比 = 5.60，95%置信区间：2.55，12.46）与新冠肺炎严重程度时间显著相关。
结论与建议
新冠肺炎患者的严重程度中位时间较短，年龄较大、合并症、高温和高血压等因素均为严重程度时间的独立预测因素。体温高、血压高、有合并症和年龄较大的患者应成为旨在缩短病程和改善临床结局的干预重点。
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