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COVID-19 住院系统性硬化症患者的预后:来自全国住院患者样本的见解。

Outcomes in systemic sclerosis patients hospitalized with COVID-19: Insight from the National Inpatient Sample.

作者信息

Cheema Huzaifa Ahmad, Akhlaq Anum, Mustafa Biah, Shahid Abia, Ayyan Muhammad, Edigin Ehizogie

机构信息

Department of Medicine, King Edward Medical University, Lahore, Pakistan.

Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

J Scleroderma Relat Disord. 2024 Feb;9(1):16-22. doi: 10.1177/23971983231210340. Epub 2023 Nov 21.

Abstract

OBJECTIVE

COVID-19, a respiratory infection caused by the novel coronavirus SARS-CoV-2, can cause varying degrees of illness ranging from mild respiratory illness to severe respiratory failure. Systemic sclerosis is a chronic autoimmune disease, with an increased prevalence of infections as compared to the general population. In this study, we compare the clinical outcomes and resource utilization for COVID-19 hospitalizations in patients with and without systemic sclerosis.

METHODS

We used the National Inpatient Sample database, 2020, to study the characteristics, morbidity, mortality, cost, and resource utilization among primary COVID-19 hospitalizations with and without systemic sclerosis.

RESULTS

There were 1,050,040 patients aged ⩾ 18 years with a diagnosis of COVID-19. Of these, 775 (0.07%) patients had a secondary diagnosis of systemic sclerosis. Although there was no statistically significant difference regarding individual outcomes; in-hospital mortality, vasopressor use, cardiac arrest, acute kidney injury, and disposition to facility were numerically higher in hospitalizations with systemic sclerosis. The composite endpoint of major adverse events was higher in the systemic sclerosis cohort (adjusted odds ratio 1.52, 95% confidence interval: 1.06-2.17, = 0.022).

CONCLUSION

COVID-19 patients with systemic sclerosis had worse outcomes (i.e. higher composite endpoint of major adverse events) than those without systemic sclerosis. Further studies are needed to establish a better understanding of the relationship between COVID-19 and systemic sclerosis.

摘要

目的

新型冠状病毒SARS-CoV-2引起的呼吸道感染COVID-19可导致从轻度呼吸道疾病到严重呼吸衰竭的不同程度病症。系统性硬化症是一种慢性自身免疫性疾病,与普通人群相比感染患病率更高。在本研究中,我们比较了患有和未患有系统性硬化症的COVID-19住院患者的临床结局和资源利用情况。

方法

我们使用2020年全国住院患者样本数据库,研究患有和未患有系统性硬化症的原发性COVID-19住院患者的特征、发病率、死亡率、费用和资源利用情况。

结果

共有1,050,040名年龄≥18岁且诊断为COVID-19的患者。其中,775名(0.07%)患者有系统性硬化症的二次诊断。尽管在个体结局方面无统计学显著差异;但患有系统性硬化症的住院患者在院内死亡率、血管升压药使用、心脏骤停、急性肾损伤和转至其他医疗机构的比例在数值上更高。系统性硬化症队列中主要不良事件的复合终点更高(调整优势比1.52,95%置信区间:1.06 - 2.17,P = 0.022)。

结论

患有系统性硬化症的COVID-19患者比未患有系统性硬化症的患者结局更差(即主要不良事件的复合终点更高)。需要进一步研究以更好地理解COVID-19与系统性硬化症之间的关系。

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