Naito Keisuke, Narita Tomoyo, Murata Yukari, Morimura Naoto
Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, 8-1 Nishi-Shinjuku 2-chome, Shinjuku-ku, Tokyo, Japan.
Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo, Japan.
IJID Reg. 2022 Mar;2:8-15. doi: 10.1016/j.ijregi.2021.11.001. Epub 2021 Nov 17.
The Tokyo Metropolitan Government has been implementing facility-based isolation of asymptomatic/mild coronavirus disease (COVID-19) patients to facilitate timely hospital referral. However, there are only a few published studies in prehospital settings, and the factors associated with hospital transfer are unclear. Our study identified the factors associated with COVID-19 deterioration in a prehospital setting.
This case-control study assessed the risk factors for hospital transfer from isolation facilities and the need for ambulance transport due to deterioration among COVID-19 patients, using multivariate logistic regression analysis.
In total, 10 590 patients (median age 34 years), with male predominance (61.1%), were included. 367 (3.5%) were transferred to hospital, of whom 44 (12.0%) required ambulance transport. Hypertension, diabetes, and bronchial asthma were prevalent in 704 (6.6%), 195 (1.8%), and 305 (2.9%) patients, respectively. After adjustment, older age, male sex, higher body mass index (BMI), and comorbidities (including diabetes, inflammatory bowel disease, and bronchial asthma) were associated with hospital transfer. Older age, male sex, and higher BMI significantly increased the risk of transfer by ambulance.
Our results may be beneficial for the development of intervention measures for probable future COVID-19 waves.
东京都政府一直在对无症状/轻症冠状病毒病（COVID-19）患者实施基于设施的隔离，以便及时转诊至医院。然而，院前环境下发表的研究较少，且与医院转运相关的因素尚不清楚。我们的研究确定了院前环境下与COVID-19病情恶化相关的因素。
本病例对照研究使用多因素逻辑回归分析，评估了COVID-19患者从隔离设施转至医院的危险因素以及因病情恶化而需要救护车转运的情况。
共纳入10590例患者（中位年龄34岁），男性占主导（61.1%）。367例（3.5%）被转至医院，其中44例（12.0%）需要救护车转运。高血压、糖尿病和支气管哮喘分别在704例（6.6%）、195例（1.8%）和305例（2.9%）患者中较为常见。调整后，年龄较大、男性、较高的体重指数（BMI）以及合并症（包括糖尿病、炎症性肠病和支气管哮喘）与转至医院有关。年龄较大、男性和较高的BMI显著增加了通过救护车转运的风险。
我们的结果可能有助于为未来可能出现的COVID-19疫情制定干预措施。
