Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru.
Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru; Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru.
Travel Med Infect Dis. 2022 Nov-Dec;50:102472. doi: 10.1016/j.tmaid.2022.102472. Epub 2022 Oct 17.
To explore the association between the use of prehospital medications and the development of fatal outcomes in patients who required hospitalization due to coronavirus disease-2019 (COVID-19).
This retrospective cohort study included adult patients who were hospitalized due to COVID-19. Demographic, clinical, and laboratory data, prehospital medication history, and fatal outcome development (use of high-flow oxygen therapy, intensive care unit [ICU] admission, or mortality) were extracted from the medical records of patients who were admitted due to COVID-19 to the Carlos Seguín Escobedo National Hospital of Arequipa, Peru during July to September 2021, the period after the second wave of COVID-19 cases in Peru. Survival was analyzed using the Cox proportional hazards model, and crude hazard ratios and adjusted hazard ratios (aHR) with their respective 95% confidence intervals (95% CI) were calculated.
A total of 192 patients were evaluated, of whom 62% were males and 46.9% did not require oxygen support at admission. Additionally, 64.6% used nonsteroidal anti-inflammatory drugs, 35.4% used corticosteroids, 28.1% used macrolides or ceftriaxone, 24.5% used ivermectin, and 21.9% used warfarin before hospitalization. Of the patients, 30.2% developed a fatal outcome during follow-up. The multivariate analysis revealed that prehospital corticosteroid use was independently associated with the fatal outcome due to COVID-19 with an aHR = 5.29 (95%CI: 1.63-17.2).
Prehospital corticosteroid use was associated with a 5-fold increased risk of fatal outcome development.
探讨因 2019 冠状病毒病（COVID-19）住院的患者在院前使用药物与致命结局发展之间的关联。
本回顾性队列研究纳入了因 COVID-19 住院的成年患者。从 2021 年 7 月至 9 月期间秘鲁阿雷基帕卡洛斯·塞古因·埃斯科贝多国立医院因 COVID-19 住院的患者病历中提取人口统计学、临床和实验室数据、院前用药史以及致命结局（使用高流量吸氧、入住重症监护病房（ICU）或死亡）的发展情况。使用 Cox 比例风险模型分析生存情况，并计算了未经调整的危险比（HR）和调整后的危险比（aHR）及其各自的 95%置信区间（95%CI）。
共评估了 192 名患者，其中 62%为男性，46.9%入院时无需吸氧支持。此外，64.6%使用非甾体类抗炎药，35.4%使用皮质类固醇，28.1%使用大环内酯类或头孢曲松，24.5%使用伊维菌素，21.9%在住院前使用华法林。在随访期间，30.2%的患者发生了致命结局。多变量分析显示，院前皮质类固醇的使用与 COVID-19 致死结局独立相关，aHR=5.29（95%CI：1.63-17.2）。
院前皮质类固醇的使用与致命结局的发生风险增加 5 倍相关。
