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[马德里自治区75岁以上人群中与新型冠状病毒肺炎死亡相关的因素]

[Factors associated with mortality due to SARS-CoV-2 in the population over 75 years of age in the Community of Madrid].

作者信息

Mostaza J M, Salinero-Fort M A, Cardenas-Valladolid J, Rodríguez-Artalejo F, Díaz-Almirón M, Vich-Pérez P, San Andrés-Rebollo F J, Vicente I, Lahoz C

机构信息

Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España.

Fundación de Investigación Biosanitaria y de Innovación de Atención Primaria (FIIBAP), Instituto de Investigación del Hospital La Paz (IdIPAZ); Red de Investigación en pacientes crónicos (REDISSEC); Subdirección general de Investigación en Salud, Ministerio de Sanidad, Madrid, España.

出版信息

Rev Clin Esp. 2022 Oct;222(8):468-478. doi: 10.1016/j.rce.2022.06.002. Epub 2022 Jun 14.

Abstract

OBJECTIVE

Various studies have identified factors associated with risk of mortality in patients with SARS-CoV-2 infection. However, their sample size has often been limited and their results partially contradictory. This study evaluated factors associated with COVID-19 mortality in the population of Madrid over 75 years of age, in infected patients, and in hospitalized patients up to January 2021.

PATIENTS AND METHODS

This population-based cohort study analyzed all residents of the Community of Madrid born before January 1, 1945 who were alive as of December 31, 2019. Demographic and clinical data were obtained from primary care electronic medical records (PC-Madrid), data on hospital admissions from the (CMBD, Minimum Data Set), and data on mortality from the (INDEF, National Death Index). Data on SARS-CoV-2 infection, hospitalization, and death were collected from March 1, 2020 to January 31, 2021.

RESULTS

A total of 587,603 subjects were included in the cohort. Of them, 41,603 (7.1%) had confirmed SARS-CoV-2 infection, of which 22,362 (53.7% of the infected individuals) were hospitalized and 11,251 (27%) died. Male sex and age were the factors most closely associated with mortality, though many comorbidities also had an influence. The associations were stronger in the analysis of the total population than in the analysis of infected or hospitalized patients. Mortality among hospitalized patients was lower during the second wave (33.4%) than during the first wave (41.2%) of the pandemic.

CONCLUSION

Age, sex, and numerous comorbidities are associated with risk of death due to COVID-19. Mortality in hospitalized patients declined notably after the first wave of the pandemic.

摘要

目的

多项研究已确定了与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者死亡风险相关的因素。然而,这些研究的样本量往往有限,其结果也存在部分矛盾之处。本研究评估了截至2021年1月,马德里75岁以上人群、感染患者及住院患者中与新型冠状病毒肺炎(COVID-19)死亡相关的因素。

患者与方法

这项基于人群的队列研究分析了马德里自治区所有在1945年1月1日前出生且截至2019年12月31日仍在世的居民。人口统计学和临床数据来自基层医疗电子病历(PC-Madrid)、医院入院数据(CMBD,最小数据集)以及死亡数据(INDEF,国家死亡指数)。SARS-CoV-2感染、住院和死亡数据收集于2020年3月1日至2021年1月31日期间。

结果

队列共纳入587,603名受试者。其中,41,603人(7.1%)确诊感染SARS-CoV-­2,其中22,362人(占感染个体的53.7%)住院治疗,11,251人(27%)死亡。男性和年龄是与死亡率最密切相关的因素,不过许多合并症也有影响。在对总人口的分析中,这些关联比在对感染患者或住院患者的分析中更强。在疫情的第二波期间,住院患者的死亡率(33.4%)低于第一波期间(41.2%)。

结论

年龄、性别和多种合并症与COVID-19死亡风险相关。在疫情第一波过后,住院患者的死亡率显著下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf89/9193184/32e7db2cf78f/gr1_lrg.jpg

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