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接受家庭远程监测的 COVID-19 哮喘门诊患者的特征与结局

Characteristics and outcomes of asthmatic outpatients with COVID-19 who receive home telesurveillance.

作者信息

Beurnier Antoine, Yordanov Youri, Dechartres Agnès, Dinh Aurélien, Debuc Erwan, Lescure François-Xavier, Jourdain Patrick, Jaulmes Luc, Humbert Marc

机构信息

Université Paris-Saclay, Faculty of Medicine, INSERM UMR_S 999, Service de physiologie et d'explorations fonctionnelles respiratoires, CRISALIS/F-CRIN Network, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

Sorbonne Université, Assistance Publique-Hopitaux de Paris (AP-HP), Hôpital Saint Antoine, Service d'Accueil des Urgences, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMR-S 1136, Paris, France.

出版信息

ERJ Open Res. 2022 Oct 24;8(4). doi: 10.1183/23120541.00012-2022. eCollection 2022 Oct.

Abstract

BACKGROUND

The prognosis of asthmatic outpatients with COVID-19 needs to be clarified. The objectives of this study were: 1) to investigate the characteristics and outcomes of asthmatic patients receiving initial ambulatory care and home monitoring for COVID-19 with Covidom, a telesurveillance solution; and 2) to compare the characteristics and outcomes between asthmatic and non-asthmatic patients.

METHODS

Inclusion criteria were age ≥18 years, suspected or confirmed COVID-19 diagnosis allowing initial ambulatory care, registration in Covidom between March 2020 and April 2021 and completion of the initial medical questionnaire. We compared clinical characteristics and outcomes between asthmatic and non-asthmatic patients, and we evaluated whether asthma was independently associated with clinical worsening (hospitalisation or death) within 30 days follow-up using a multivariate logistic regression model.

RESULTS

33 815 patients met the inclusion criteria. Asthma was reported in 4276 (12.6%). The main comorbidities among asthmatic patients were obesity (23.1%), hypertension (12.7%) and diabetes (4.5%). As compared with non-asthmatic patients, asthmatic patients were more often female (70.0 62.1%, p<0.001), of younger age (42.2 43.8 years, p<0.001) and obese (23.1 17.6%, p<0.001). The rate of hospitalisation did not differ significantly (4.7 4.2%, p=0.203) and no asthmatic patient died during follow-up ( 25 non-asthmatic patients, 0.1%; p=0.109). In multivariate analysis, asthma was independently associated with higher risk of clinical worsening (OR 1.23, 95% CI 1.04-1.44, p=0.013).

CONCLUSION

In a large French cohort of patients receiving initial ambulatory care and home monitoring for COVID-19, asthma was independently associated with higher risk of clinical worsening although no asthmatic patient died within the 30 days follow-up.

摘要

背景

哮喘门诊患者感染新型冠状病毒肺炎(COVID-19)后的预后情况有待明确。本研究的目的是:1)利用远程监测解决方案Covidom,调查接受COVID-19初始门诊治疗和居家监测的哮喘患者的特征及转归;2)比较哮喘患者与非哮喘患者的特征及转归。

方法

纳入标准为年龄≥18岁、疑似或确诊COVID-19且适合初始门诊治疗、于2020年3月至2021年4月期间在Covidom登记并完成初始医学问卷。我们比较了哮喘患者与非哮喘患者的临床特征及转归,并使用多因素逻辑回归模型评估哮喘是否与30天随访内的临床病情恶化(住院或死亡)独立相关。

结果

33815例患者符合纳入标准。其中4276例(12.6%)报告有哮喘。哮喘患者的主要合并症为肥胖(23.1%)、高血压(12.7%)和糖尿病(4.5%)。与非哮喘患者相比,哮喘患者女性更多(70.0%对62.1%,p<0.001)、年龄更小(42.2岁对43.8岁,p<0.001)且肥胖者更多(23.1%对17.6%,p<0.001)。住院率无显著差异(4.7%对4.2%,p=0.203),随访期间无哮喘患者死亡(25例非哮喘患者死亡,0.1%;p=0.109)。多因素分析显示,哮喘与临床病情恶化风险较高独立相关(比值比1.23,95%置信区间1.04-1.44,p=0.013)。

结论

在法国一个接受COVID-19初始门诊治疗和居家监测的大型队列中,尽管在30天随访内无哮喘患者死亡,但哮喘与临床病情恶化风险较高独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f76c/9589327/ca8a7be9cc7c/00012-2022.01.jpg

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