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入住重症监护病房的COVID-19患者的临床和流行病学特征:一项为期两年的回顾性分析

Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A Two-Year Retrospective Analysis.

作者信息

E Silva Malzone Juliana Raimondo, Ribeiro Ana Paula, de Souza Tatiane Silva, Wilbert Debora Driemeyer, Novo Neil Ferreira, Juliano Yara

机构信息

Health Science Post-Graduate Department, School of Medicine, University Santo Amaro, São Paulo 04829-300, Brazil.

Physical Therapy Department, School of Medicine, University of Sao Paulo, São Paulo 05360-160, Brazil.

出版信息

Life (Basel). 2023 Mar 9;13(3):741. doi: 10.3390/life13030741.

Abstract

UNLABELLED

In March 2020, COVID-19 was characterized as a pandemic by the World Health Organization. Hospitalized patients affected by COVID-19 presented with severe respiratory and motor impairment, especially those who required intensive treatment and invasive mechanical ventilation, with sequelae that extended after the period of hospitalization. Thus, the aim of the current study was to verify the clinical and epidemiological characteristics of patients with COVID-19 admitted to the Intensive Care Unit in 2020 and 2021, according to age group.

METHODS

A retrospective cohort study. Data were collected through the "ICUs Brasileiras" between March 2020 and November 2021 for severe acute respiratory syndrome (SARS) due to COVID-19. The following were analyzed: the number of hospital admissions, days in the ICU and hospital, clinical aspects (non-invasive or invasive ventilatory support, comorbidities, frailty, SAPS 3 and SOFA severity scales, use of amines and renal support), and ICU and hospital mortality rate.

RESULTS

A total of 166,966 ICU hospital admissions were evaluated over the evaluated quarters. The main results showed a peak in the number of hospitalizations between March and May 2021, with a higher percentage of males. The peak of ICU admissions for 7 days was between March and May 2021 and 21 days between March and May 2020. In addition, higher deaths were observed in the age groups between 40 and 80 years between 2020 and 2021, with the group above 81 being the age group with the highest mortality. Mortality in the ICU of ventilated patients was higher in the age group above 70 years. Another observation was the predominance of SAPS 3 and the peak of mechanical ventilation for more than 7 days between June and August 2021.

CONCLUSION

The clinical and epidemiological characteristics of patients with COVID-19 were influenced by age group, showing higher mortality over 81 years and over 70 years in the ICU supported by mechanical ventilation, maintained for 7 days from June to August 2021. The years 2020 and 2021 also showed differences for patients with COVID-19, with greater hospitalization between March and May 2021, especially in the ICU for 7 days, and between March and May 2020 for the 21-day period.

摘要

未标注

2020年3月,新型冠状病毒肺炎被世界卫生组织列为大流行病。感染新型冠状病毒肺炎的住院患者出现严重的呼吸和运动功能障碍,尤其是那些需要重症治疗和有创机械通气的患者,其后遗症在住院期过后仍会持续。因此,本研究的目的是根据年龄组,核实2020年和2021年入住重症监护病房的新型冠状病毒肺炎患者的临床和流行病学特征。

方法

一项回顾性队列研究。通过“巴西重症监护病房”收集2020年3月至2021年11月期间因新型冠状病毒肺炎导致的严重急性呼吸综合征(SARS)的数据。分析了以下内容:住院人数、在重症监护病房和医院的天数、临床情况(无创或有创通气支持、合并症、虚弱、序贯器官衰竭评估(SOFA)严重程度量表、血管活性药物使用情况和肾脏支持)以及重症监护病房和医院的死亡率。

结果

在评估的季度中,共评估了166966例重症监护病房住院病例。主要结果显示,2021年3月至5月住院人数达到峰值,男性比例更高。2021年3月至5月为7天重症监护病房住院人数峰值期,2020年3月至5月为21天峰值期。此外,2020年至2021年期间,40至80岁年龄组死亡人数较多,81岁以上年龄组死亡率最高。70岁以上年龄组的有创通气患者在重症监护病房的死亡率更高。另一个观察结果是序贯器官衰竭评估(SAPS)3占主导地位,2021年6月至8月期间机械通气超过7天达到峰值。

结论

新型冠状病毒肺炎患者的临床和流行病学特征受年龄组影响,81岁以上及70岁以上接受机械通气支持的重症监护病房患者死亡率更高,2021年6月至8月期间维持7天。2020年和2021年新型冠状病毒肺炎患者情况也存在差异,2021年3月至5月住院人数更多,尤其是在重症监护病房7天住院期,2020年3月至5月为21天住院期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f7e/10059043/76bb641390ac/life-13-00741-g001.jpg

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