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伦巴第地区 110593 例新冠肺炎住院患者:对病例特征、风险因素和临床结局的全地区分析。

The First 110,593 COVID-19 Patients Hospitalised in Lombardy: A Regionwide Analysis of Case Characteristics, Risk Factors and Clinical Outcomes.

机构信息

Vita-Salute San Raffaele University, Milan, Italy.

European Observatory on Health Systems and Policies, Brussels, Belgium.

出版信息

Int J Public Health. 2022 May 11;67:1604427. doi: 10.3389/ijph.2022.1604427. eCollection 2022.

Abstract

To describe the monthly distribution of COVID-19 hospitalisations, deaths and case-fatality rates (CFR) in Lombardy (Italy) throughout 2020. We analysed de-identified hospitalisation data comprising all COVID-19-related admissions from 1 February 2020 to 31 December 2020. The overall survival (OS) from time of first hospitalisation was estimated using the Kaplan-Meier method. We estimated monthly CFRs and performed Cox regression models to measure the effects of potential predictors on OS. Hospitalisation and death peaks occurred in March and November 2020. Patients aged ≥70 years had an up to 180 times higher risk of dying compared to younger patients [70-80: HR 58.10 (39.14-86.22); 80-90: 106.68 (71.01-160.27); ≥90: 180.96 (118.80-275.64)]. Risk of death was higher in patients with one or more comorbidities [1: HR 1.27 (95% CI 1.20-1.35); 2: 1.44 (1.33-1.55); ≥3: 1.73 (1.58-1.90)] and in those with specific conditions (hypertension, diabetes). Our data sheds light on the Italian pandemic scenario, uncovering mechanisms and gaps at regional health system level and, on a larger scale, adding to the body of knowledge needed to inform effective health service planning, delivery, and preparedness in times of crisis.

摘要

描述 2020 年意大利伦巴第(Lombardy)地区 COVID-19 住院、死亡和病死率(CFR)的月度分布。我们分析了包含 2020 年 2 月 1 日至 12 月 31 日所有 COVID-19 相关住院的去识别化住院数据。首次住院后的总生存率(OS)采用 Kaplan-Meier 法估计。我们估计了每月的 CFR,并进行 Cox 回归模型以衡量潜在预测因素对 OS 的影响。住院和死亡高峰出现在 2020 年 3 月和 11 月。与年轻患者相比,年龄≥70 岁的患者死亡风险高 180 倍[70-80 岁:HR 58.10(39.14-86.22);80-90 岁:106.68(71.01-160.27);≥90 岁:180.96(118.80-275.64)]。患有一种或多种合并症的患者[1:HR 1.27(95%CI 1.20-1.35);2:1.44(1.33-1.55);≥3:1.73(1.58-1.90)]和患有特定疾病(高血压、糖尿病)的患者死亡风险更高。我们的数据揭示了意大利大流行的情况,揭示了区域卫生系统层面的机制和差距,并且在更大的范围内,为有效规划卫生服务、提供服务和危机准备提供了所需的知识体系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/138f/9131487/618952358f98/ijph-67-1604427-g001.jpg

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