Optum Epidemiology, Boston, MA, United States of America.
IQVIA, King of Prussia, PA, United States of America.
PLoS One. 2022 Jul 20;17(7):e0271501. doi: 10.1371/journal.pone.0271501. eCollection 2022.
Electronic health record (EHR) databases provide an opportunity to facilitate characterization and trends in patients with COVID-19.
Patients with COVID-19 were identified based on an ICD-10 diagnosis code for COVID-19 (U07.1) and/or a positive SARS-CoV-2 viral lab result from January 2020 to November 2020. Patients were characterized in terms of demographics, healthcare utilization, clinical comorbidities, therapies, laboratory results, and procedures/care received, including critical care, intubation/ventilation, and occurrence of death were described, overall and by month.
There were 393,773 patients with COVID-19 and 56,996 with a COVID-19 associated hospitalization. A greater percentage of patients hospitalized with COVID-19 relative to all COVID-19 cases were older, male, African American, and lived in the Northeast and South. The most common comorbidities before admission/infection date were hypertension (40.8%), diabetes (29.5%), and obesity (23.8%), and the most common diagnoses during hospitalization were pneumonia (59.6%), acute respiratory failure (44.8%), and dyspnea (28.0%). A total of 85.7% of patients hospitalized with COVID-19 had CRP values > 10 mg/L, 75.5% had fibrinogen values > 400 mg/dL, and 76.8% had D-dimer values > 250 ng/mL. Median values for platelets, CRP, lactate dehydrogenase, D-dimer, and fibrinogen tended to decrease from January-March to November. The use of chloroquine/hydroxychloroquine during hospitalization peaked by March (71.2%) and was used rarely by May (5.1%) and less than 1% afterwards, while the use of remdesivir had increased by May (10.0%) followed by dexamethasone by June (27.7%). All-cause mortality was 3.2% overall and 15.0% among those hospitalized; 21.0% received critical care and 16.0% received intubation/ventilation/ECMO.
This study characterizes US patients with COVID-19 and their management during hospitalization over the first eleven months of this disease pandemic.
电子健康记录 (EHR) 数据库提供了一个机会，可以方便地描述和跟踪 COVID-19 患者的特征和趋势。
根据 COVID-19 的 ICD-10 诊断代码 (U07.1) 和/或 2020 年 1 月至 2020 年 11 月期间 SARS-CoV-2 病毒检测结果为阳性，确定 COVID-19 患者。根据人口统计学特征、医疗保健利用情况、临床合并症、治疗方法、实验室结果和接受的治疗/护理（包括重症监护、插管/通气和死亡的发生）来描述患者，总体上并按月进行描述。
共 393773 例 COVID-19 患者，56996 例 COVID-19 相关住院患者。与所有 COVID-19 病例相比，住院 COVID-19 患者中年龄较大、男性、非裔美国人以及居住在东北部和南部的比例更高。入院/感染日期前最常见的合并症是高血压 (40.8%)、糖尿病 (29.5%)和肥胖 (23.8%)，住院期间最常见的诊断是肺炎 (59.6%)、急性呼吸衰竭 (44.8%)和呼吸困难 (28.0%)。COVID-19 住院患者中，CRP 值>10mg/L 的比例为 85.7%，纤维蛋白原值>400mg/dL 的比例为 75.5%，D-二聚体值>250ng/mL 的比例为 76.8%。血小板、CRP、乳酸脱氢酶、D-二聚体和纤维蛋白原的中位数从 1 月至 3 月呈下降趋势，至 11 月。住院期间使用氯喹/羟氯喹的比例在 3 月达到高峰（71.2%），5 月（5.1%）和之后很少使用，不到 1%，而使用瑞德西韦的比例在 5 月（10.0%）增加，6 月（27.7%）使用地塞米松。总死亡率为 3.2%，住院患者死亡率为 15.0%；21.0%的患者接受重症监护，16.0%的患者接受插管/通气/ECMO。
本研究描述了美国 COVID-19 患者的特征及其在疾病流行的前 11 个月期间的住院管理情况。
