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疫情早期内布拉斯加州和爱荷华州西南部的新冠病毒死亡率及治疗方法

COVID-19 Mortality and Therapeutics in Nebraska and Southwest Iowa during Early Pandemic.

作者信息

Destache Christopher J, Ahmad Faran, Rajendrapasad Sanu, Loranger Austin, Pruett William, Jagan Nikhal, Krajicek Bryan, Schmidt David, Quimby David, Velagapudi Manasa, Boldt Dayla, Hayes Sarah, Anthone Jennifer, Kessel Brittney, Vivekanandan Renuga

机构信息

School of Medicine, Creighton University, Omaha, NE 68178, USA.

School of Pharmacy & Health Professions, Omaha, NE 68178, USA.

出版信息

Pharmacy (Basel). 2022 Jun 24;10(4):69. doi: 10.3390/pharmacy10040069.

Abstract

Different pharmacotherapeutics have been introduced, and then stopped or continued, for the treatment of SARS-CoV-2. We evaluated the risks associated with mortality from SARS-CoV-2 infection. METHODS: Data was concurrently or retrospectively captured on COVID-19 hospitalized patients from 6 regional hospitals within the health system. Demographic details, the source of SARS-CoV-2 infection, concomitant disease status, as well as the therapeutic agents used for treating SARS-CoV-2 (e.g., antimicrobials, dexamethasone, convalescent plasma, tocilizumab, and remdesivir) were recorded. Discrete and continuous variables were analyzed using SPSS (ver. 27). Logistic regression identified variables significantly correlated with mortality. RESULTS: 471 patients (admitted from 1 March 2020 through 15 July 2020) were reviewed. Mean (±SD) age and body weight (kg) were 62.5 ± 17.7 years and 86.3 ± 27.1 kg, respectively. Patients were Caucasian (50%), Hispanic (34%), African-American (10%), or Asian (5%). Females accounted for 52% of patients. Therapeutic modalities used for COVID-19 illness included remdesivir (16%), dexamethasone (35%), convalescent plasma (17.8%), and tocilizumab (5.8%). The majority of patients returned home (62%) or were transferred to a skilled nursing facility (23%). The overall mortality from SARS-CoV-2 was 14%. Logistic regression identified variables significantly correlated with mortality. Intubation, receipt of dexamethasone, African-American or Asian ethnicity, and being a patient from a nursing home were significantly associated with mortality (x2 = 86.36 (13) p < 0.0005). CONCLUSIONS: SARS-CoV-2 infected hospitalized patients had significant mortality risk if they were intubated, received dexamethasone, were of African-American or Asian ethnicity, or occupied a nursing home bed prior to hospital admission.

摘要

为治疗新型冠状病毒肺炎(SARS-CoV-2),已采用了不同的药物治疗方法,随后有些被停用,有些则继续使用。我们评估了与SARS-CoV-2感染导致的死亡相关的风险。方法:对卫生系统内6家地区医院的COVID-19住院患者的数据进行了同步或回顾性收集。记录了人口统计学细节、SARS-CoV-2感染源、伴随疾病状况以及用于治疗SARS-CoV-2的治疗药物(如抗菌药物、地塞米松、康复期血浆、托珠单抗和瑞德西韦)。使用SPSS(版本27)对离散和连续变量进行分析。逻辑回归确定了与死亡率显著相关的变量。结果:对471例患者(2020年3月1日至2020年7月15日入院)进行了回顾。平均(±标准差)年龄和体重(kg)分别为62.5±17.7岁和86.3±27.1kg。患者为白种人(50%)、西班牙裔(34%)、非裔美国人(10%)或亚洲人(5%)。女性占患者的52%。用于COVID-19疾病的治疗方式包括瑞德西韦(16%)、地塞米松(35%)、康复期血浆(17.8%)和托珠单抗(5.8%)。大多数患者回家(62%)或被转移到专业护理机构(23%)。SARS-CoV-2的总体死亡率为14%。逻辑回归确定了与死亡率显著相关的变量。插管治疗、接受地塞米松治疗、非裔美国人或亚洲种族以及来自养老院的患者与死亡率显著相关(x2 = 86.36(13)p < 0.0005)。结论:SARS-CoV-2感染的住院患者如果接受插管治疗、接受地塞米松治疗、是非裔美国人或亚洲种族,或者在入院前占用养老院床位,则有显著的死亡风险。

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