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巴尼亚卢卡县新冠肺炎患者住院及死亡率相关的临床和流行病学危险因素:一项对40000名患者的回顾性观察队列研究

Clinical and epidemiological risk factors associated with hospitalization and mortality rate of COVID-19 patients in Banja Luka County: A retrospective observational cohort study on 40,000 patients.

作者信息

Pilipovic Broceta Natasa, Todorovic Nevena, Skrbic Ranko, Acimovic Jela, Strbac Savka, Soldatovic Ivan

机构信息

Department of Family Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka 78000, The Republic of Srpska, Bosnia and Herzegovina.

Family Medicine Teaching Centre, Primary Health Care Centre Banja Luka, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina.

出版信息

J Family Med Prim Care. 2024 May;13(5):2130-2137. doi: 10.4103/jfmpc.jfmpc_1641_23. Epub 2024 May 24.

Abstract

CONTEXT

Since beginning of the coronavirus disease (COVID-19) it became clear that severe forms of this infection have primarily affected patients with chronic conditions.

AIMS

The aim of the study was to explore clinical and epidemiological characteristics associated with COVID 19 outcomes.

SETTINGS AND DESIGN

The retrospective observational study included 40,692 citizens of Banja Luka County, Bosnia and Herzegovina, who were confirmed as reverse transcriptase polymerase chain reaction (RT-PCR) positive on COVID-19 at a primary healthcare centre from March 2020 to September 2022.

METHODS AND MATERIALS

Epidemiological data were obtained from Web-Medic medical records of patients. The COVID-19 data were obtained from COVID-19 data sheets comprised of patients' RT-PCR testing forms, surveillance forms for severe acute respiratory syndrome coronavirus-2 status, and a map of their positive and isolated contacts.

STATISTICAL ANALYSIS USED

Differences regarding the distributions of patients between groups were analysed using the Pearson chi-square test and Mantel-Haenszel chi-square test for trends, while differences in mean values were compared using an independent sample -test.

RESULTS

The average age of hospitalised patients was significantly higher compared to the age of non-hospitalised patients ( < 0.001). The average age of patients with lethal outcomes was nearly twice as high in comparison to patients with non-lethal outcomes ( < 0.001). Male patients had a higher hospitalization and mortality rate ( < 0.001). The highest hospitalization rate was in patients with chronic renal failure (CRF), diabetes and cardiovascular diseases (CVDs), while the death rate was the highest among patients with CRF and hearth comorbidities. Patients with fatigue and appetite loss had a higher percentage of lethal outcomes. Vaccinated patients had a significantly lower rate of lethal outcome.

CONCLUSIONS

Clinical symptoms, signs and outcomes, are posing as predictive parameters for further management of COVID-19. Vaccination has an important role in the clinical outcomes of COVID-19.

摘要

背景

自冠状病毒病(COVID-19)开始以来,很明显这种感染的严重形式主要影响患有慢性病的患者。

目的

本研究的目的是探讨与COVID-19结局相关的临床和流行病学特征。

设置与设计

这项回顾性观察研究纳入了波斯尼亚和黑塞哥维那巴尼亚卢卡县的40692名公民,他们于2020年3月至2022年9月在一家初级医疗保健中心经逆转录聚合酶链反应(RT-PCR)确诊为COVID-19阳性。

方法与材料

流行病学数据来自患者的网络医疗记录。COVID-19数据来自COVID-19数据表,该表包括患者的RT-PCR检测表、严重急性呼吸综合征冠状病毒2状态监测表以及其阳性和隔离接触者地图。

所用统计分析方法

使用Pearson卡方检验和Mantel-Haenszel卡方检验趋势分析组间患者分布的差异,而使用独立样本t检验比较均值差异。

结果

住院患者的平均年龄显著高于未住院患者(P<0.001)。与非致命结局患者相比,致命结局患者的平均年龄几乎高出一倍(P<0.001)。男性患者的住院率和死亡率更高(P<0.001)。住院率最高的是慢性肾衰竭(CRF)、糖尿病和心血管疾病(CVD)患者,而死亡率最高的是CRF和心脏合并症患者。出现疲劳和食欲减退的患者致命结局的比例更高。接种疫苗的患者致命结局发生率显著更低。

结论

临床症状、体征和结局可作为COVID-19进一步管理的预测参数。疫苗接种在COVID-19的临床结局中具有重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f29/11213400/3684b9c81c20/JFMPC-13-2130-g001.jpg

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