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智利首例大流行期间住院 COVID-19 患者的药物治疗和临床结局。

Pharmacotherapy and clinical outcomes of hospitalized COVID-19 patients in Chile during the first wave of pandemic.

机构信息

Instituto de Farmacia, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile.

Escuela de Química y Farmacia, Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.

出版信息

Rev Med Chil. 2023 May;151(5):541-550. doi: 10.4067/s0034-98872023000500541.

Abstract

BACKGROUND

The largest growth in cases of COVID-19 worldwide during 2020 was in the Americas, and Chile was one of the most affected countries.

AIM

To describe, characterize, and evaluate the use of drugs as treatment for COVID-19 in hospitalized patients in Chile during the first wave of the pandemic.

METHODS

We performed a multicenter, observational study that included 442 patients with confirmed SARS-CoV-2 infection admitted in Chilean hospitals between March 21 and September 22, 2020. The analysis included demographics, comorbidities, specific drug therapy, and outcomes over a 28-day follow-up period.

RESULTS

The median age of patients was 68 years (IQR 55-73), and 38.9% were women. The most common comorbidities were hypertension (57.7%) and diabetes (36.9%). Fifty-seven (12.9%) patients died. Hypertension (HR 2.99; CI 95% 1.43-6.26) and age ≥ 65 (2.14; CI 95% 1.10- 4.17) were the main predictors of mortality. Primary drugs were azithromycin (58.8%) and corticosteroids (51.1%). In this sample, azithromycin was a protective factor regarding mortality (HR 0.53; CI 95% 0.31-0.90), increasing clinical improvement and avoiding progression.

CONCLUSIONS

The patterns of use of drugs to treat COVID-19 in Chile during the first wave of the pandemic were very dynamic and followed the international, evidence-based guidelines. The low mortality rate indicates that the clinical management of hospitalized patients was adequate.

摘要

背景

2020 年全球 COVID-19 病例增长最多的地区是美洲,智利是受影响最严重的国家之一。

目的

描述、分析和评估智利在大流行第一波期间住院患者使用药物治疗 COVID-19 的情况。

方法

我们进行了一项多中心观察性研究,纳入了 2020 年 3 月 21 日至 9 月 22 日期间在智利医院住院的 442 例确诊 SARS-CoV-2 感染患者。分析包括人口统计学、合并症、特定药物治疗以及 28 天随访期间的结局。

结果

患者的中位年龄为 68 岁(IQR 55-73),38.9%为女性。最常见的合并症是高血压(57.7%)和糖尿病(36.9%)。57 例(12.9%)患者死亡。高血压(HR 2.99;95%CI 1.43-6.26)和年龄≥65 岁(2.14;95%CI 1.10-4.17)是死亡的主要预测因素。主要药物为阿奇霉素(58.8%)和皮质类固醇(51.1%)。在该样本中,阿奇霉素是降低死亡率的保护因素(HR 0.53;95%CI 0.31-0.90),可提高临床改善率并避免病情进展。

结论

智利在大流行第一波期间治疗 COVID-19 的药物使用模式非常活跃,并遵循了国际循证指南。低死亡率表明住院患者的临床管理是充分的。

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