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与马德里社区 75 岁以上人群因 SARS-CoV-2 导致的死亡率相关的因素。

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

机构信息

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

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, Ministerios de Sanidad, Madrid, Spain.

出版信息

Rev Clin Esp (Barc). 2022 Oct;222(8):468-478. doi: 10.1016/j.rceng.2022.06.004. Epub 2022 Aug 12.

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 Conjunto Mínimo Básico de Datos (CMBD, Minimum Data Set), and data on mortality from the Índice Nacional de Defunciones (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

多项研究已经确定了与 SARS-CoV-2 感染患者死亡风险相关的因素。然而,它们的样本量往往有限,其结果部分相互矛盾。本研究评估了马德里地区超过 75 岁人群中、感染患者以及截至 2021 年 1 月住院患者中与 COVID-19 死亡率相关的因素。

方法

本基于人群的队列研究分析了截至 2019 年 12 月 31 日所有出生于 1945 年 1 月 1 日前、居住在马德里社区的居民。从初级保健电子病历(PC-Madrid)获取人口统计学和临床数据,从 Conjunto Mínimo Básico de Datos(CMBD,最小数据集)获取住院数据,从 Índice Nacional de Defunciones(INDEF,国家死亡指数)获取死亡数据。2020 年 3 月 1 日至 2021 年 1 月 31 日收集 SARS-CoV-2 感染、住院和死亡数据。

结果

该队列共纳入 587603 名受试者。其中,41603 人(7.1%)确诊 SARS-CoV-2 感染,其中 22362 人(感染人群的 53.7%)住院,11251 人(27%)死亡。男性和年龄是与死亡率最密切相关的因素,尽管许多合并症也有影响。在总人群分析中,这些关联比在感染或住院患者分析中更强。在大流行的第一波(41.2%)和第二波(33.4%)期间,住院患者的死亡率均有所下降。

结论

年龄、性别和多种合并症与 COVID-19 死亡风险相关。大流行第一波后,住院患者的死亡率显著下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/614a/9372797/d031f0349fa3/gr1_lrg.jpg

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