Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
Department of Medicine and Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong SAR, China.
Hong Kong Med J. 2023 Oct;29(5):383-395. doi: 10.12809/hkmj219876. Epub 2023 Sep 28.
In 2020, patients with critical coronavirus disease 2019 (COVID-19) had a 28-day mortality rate of 30% to 50% worldwide; outcomes among such patients in Hong Kong were unknown. This study investigated 28-day mortality and corresponding risk factors among patients with severe or critical COVID-19 in Hong Kong.
This retrospective cohort study included adult patients with severe or critical COVID-19 who were admitted to three public hospitals in Hong Kong from 22 January to 30 September 2020. Demographics, comorbidities, symptoms, treatment, and outcomes were examined.
Among 125 patients with severe or critical COVID-19, 15 (12.0%) died within 28 days. Overall, the median patient age was 64 years; 48.0% and 54.4% of patients had hypertension and obesity, respectively. Respiratory samples were confirmed severe acute respiratory syndrome coronavirus 2 RNA-positive after a median of 3 days. The most common presenting symptom was fever (80.0% of patients); 45.6% and 32.8% of patients received care in intensive care unit and required mechanical ventilation, respectively. In logistic regression analysis comparing 28-day survivors and non-survivors, factors associated with greater 28-day mortality were older age (odds ratio [OR] per 1-year increase in age=1.12, 95% confidence interval [CI]=1.04-1.21; P=0.002), history of stroke (OR=15.96, 95% CI=1.65-154.66; P=0.017), use of renal replacement therapy (OR=15.32, 95% CI=2.67-87.83; P=0.002), and shorter duration of lopinavir-ritonavir treatment (OR per 1-day increase=0.82, 95% CI=0.68-0.98; P=0.034).
The 28-day mortality rate among patients with severe or critical COVID-19 in Hong Kong was 12.0%. Older age, history of stroke, use of renal replacement therapy, and shorter duration of lopinavir-ritonavir treatment were independent predictors of 28-day mortality.
2020 年，全球有 28 天病死率为 30%-50%的危重新冠肺炎（COVID-19）患者；香港此类患者的结局尚不清楚。本研究调查了香港重症或危重症 COVID-19 患者的 28 天病死率及相关危险因素。
这是一项回顾性队列研究，纳入了 2020 年 1 月 22 日至 9 月 30 日期间从香港 3 家公立医院收治的重症或危重症 COVID-19 成年患者。分析了患者的人口统计学、合并症、症状、治疗和结局。
在 125 例重症或危重症 COVID-19 患者中，15 例（12.0%）在 28 天内死亡。总体而言，中位患者年龄为 64 岁；分别有 48.0%和 54.4%的患者患有高血压和肥胖症。中位发病后 3 天采集呼吸道样本检测出严重急性呼吸综合征冠状病毒 2 型 RNA 阳性。最常见的首发症状是发热（80.0%的患者）；分别有 45.6%和 32.8%的患者在重症监护病房接受治疗和需要机械通气。在比较 28 天幸存者和非幸存者的二分类逻辑回归分析中，与较高 28 天病死率相关的因素包括年龄较大（每增加 1 岁的比值比[OR]为 1.12，95%置信区间[CI]为 1.04-1.21；P=0.002）、有脑卒中史（OR=15.96，95%CI=1.65-154.66；P=0.017）、接受肾脏替代治疗（OR=15.32，95%CI=2.67-87.83；P=0.002）和洛匹那韦-利托那韦治疗时间较短（OR 每增加 1 天=0.82，95%CI=0.68-0.98；P=0.034）。
香港重症或危重症 COVID-19 患者的 28 天病死率为 12.0%。年龄较大、有脑卒中史、接受肾脏替代治疗和洛匹那韦-利托那韦治疗时间较短是 28 天病死率的独立预测因素。
