印度 COVID-19 患者的相关风险因素：一项单中心回顾性队列研究。

Risk Factors associated with COVID-19 Patients in India: A Single Center Retrospective Cohort Study.

机构信息

MD Internal Medicine, Additional Director.

Consultant;Corresponding Author.

出版信息

J Assoc Physicians India. 2023 Jun;71(6):11-12. doi: 10.5005/japi-11001-0263.

DOI:10.5005/japi-11001-0263

PMID:37355843

Abstract

BACKGROUND AND OBJECTIVES

The coronavirus disease 2019 (COVID-19) outbreak has caused a worldwide pandemic, resulting in >3.8 million deaths. Our aim is to identify the risk factors associated with in-hospital mortality using survival analysis considering the characteristics and outcomes of COVID-19 patients admitted to a dedicated tertiary-care hospital in Mumbai, India.

MATERIALS AND METHODS

In a retrospective cohort study, 565 patients admitted from 28th March 2020 to 30th June 2020 were enrolled, and a follow-up was conducted till August 2020. To investigate the impact of COVID-19, survival analysis was performed using the Kaplan-Meier method. Potential risk factors associated with mortality were analyzed using logistic regression models for multivariate analysis and the Cox proportional hazards model for estimating hazard ratios (HRs).

RESULTS

From the 565 positive COVID-19 cases, 49 patients died (8.7%) and 516 (91.3%) were discharged. Overall, 119 patients (20%) required intensive care unit (ICU) admission, of which 70 (58%) patients survived. The Kaplan-Meier survival curve showed a significant association of COVID-19 infection with age (≥60; p = 0.008), hypertension (p = 0.03), dialysis (p = 0.0001), lung commodities (p = 0.01), breathlessness (p = 0.0001), severe disease upon high-resolution computed tomography (HRCT) analysis (p = 0.0001), ICU admission (p = 0.0001), and low lymphocyte count at admission (p = 0.0001). Additionally, patients receiving tocilizumab (p = 0.0001) and deprived of hydroxychloroquine (HCQ) + azithromycin (azee) (p = 0.0001) were estimated at a high risk of mortality.

INTERPRETATION AND CONCLUSION

Coronavirus disease 2019 (COVID-19) increased the risk of mortality in patients with increased age, comorbidities, and severe symptoms upon treatment with an immunosuppressant (tocilizumab). However, patients treated with HCQ + azee showed favorable results due to their antiviral effects in vitro.

摘要

背景与目的

2019 年冠状病毒病（COVID-19）疫情已在全球范围内蔓延，导致超过 380 万人死亡。我们的目的是使用生存分析来确定与在印度孟买的一家专门的三级保健医院住院的 COVID-19 患者的特征和结局相关的住院死亡率的危险因素。

材料与方法

在一项回顾性队列研究中，纳入了 2020 年 3 月 28 日至 6 月 30 日期间入院的 565 例患者，并在 2020 年 8 月进行了随访。为了研究 COVID-19 的影响，使用 Kaplan-Meier 方法进行生存分析。使用多变量分析的逻辑回归模型和 Cox 比例风险模型分析与死亡率相关的潜在危险因素，并估计风险比（HR）。

结果

在 565 例阳性 COVID-19 病例中，有 49 例死亡（8.7%），516 例（91.3%）出院。总体而言，有 119 例（20%）患者需要入住重症监护病房（ICU），其中 70 例（58%）患者存活。Kaplan-Meier 生存曲线显示 COVID-19 感染与年龄（≥60 岁；p=0.008）、高血压（p=0.03）、透析（p=0.0001）、肺部病变（p=0.01）、呼吸困难（p=0.0001）、高分辨率计算机断层扫描（HRCT）分析的严重疾病（p=0.0001）、入住 ICU（p=0.0001）和入院时淋巴细胞计数低（p=0.0001）有显著相关性。此外，接受托珠单抗治疗的患者（p=0.0001）和未接受羟氯喹（HCQ）+阿奇霉素（azee）治疗的患者（p=0.0001）的死亡率估计较高。