Kashiri Fatemeh, Sarbakhsh Parvin, Mohammadpoorasl Asghar, Seyedghasemi Navisa Sadat, Bagheri Ali, Akbari Hossein
Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran.
Arch Public Health. 2024 Jul 8;82(1):105. doi: 10.1186/s13690-024-01330-4.
Appreciating the various dimensions of the coronavirus disease 2019 (COVID-19) pandemic can improve health systems and prepare them to deal better with future pandemics and public health events. This study was conducted to investigate the association between the survival of hospitalized patients with COVID-19 and the epidemic risk stratification of the disease in Golestan province, Iran.
In this study, all patients with COVID-19 who were hospitalized in the hospitals of Golestan province of Iran from February 20, 2020, to December 19, 2022, and were registered in the Medical Care Monitoring Center (MCMC) system (85,885 individuals) were examined.The community's epidemic risk status (ERS) was determined based on the daily incidence statistics of COVID-19. The survival distribution and compare Survival in different subgroups was investigated using Kaplan-Meier and log-rank test and association between the survival and ERS by multiple Cox regression modeling.
Out of 68,983 individuals whose data were correctly recorded, the mean age was 49 (SD = 23.98) years, and 52.8% were women. In total, 11.1% eventually died. The length of hospital stay was varying significantly with age, gender, ERS, underlying diseases, and COVID-19 severity (P < 0.001 for all). The adjusted hazard ratio of death for the ERS at medium, high, and very high-risk status compared to the low-risk status increased by 19%, 26%, and 56%, respectively (P < 0.001 for all).
Enhancing preparedness, facilitating rapid rises in hospital capacities, and developing backup healthcare capacities can prevent excessive hospital referrals during health crises and further deaths.
了解2019冠状病毒病（COVID-19）大流行的各个方面有助于改善卫生系统，并使其做好更好应对未来大流行和公共卫生事件的准备。本研究旨在调查伊朗戈勒斯坦省COVID-19住院患者的生存情况与该疾病的流行风险分层之间的关联。
在本研究中，对2020年2月20日至2022年12月19日期间在伊朗戈勒斯坦省医院住院并登记在医疗保健监测中心（MCMC）系统中的所有COVID-19患者（85,885人）进行了检查。根据COVID-19的每日发病率统计确定社区的流行风险状况（ERS）。使用Kaplan-Meier法和对数秩检验研究生存分布并比较不同亚组的生存率，并通过多因素Cox回归模型研究生存率与ERS之间的关联。
在数据记录正确的68,983人中，平均年龄为49岁（标准差=23.98），女性占52.8%。共有11.1%的患者最终死亡。住院时间在年龄、性别、ERS、基础疾病和COVID-19严重程度方面存在显著差异（所有P<0.001）。与低风险状态相比，中、高和非常高风险状态的ERS的调整后死亡风险比分别增加了19%、26%和56%（所有P<0.001）。
加强准备工作、促进医院容量的快速增加以及发展备用医疗能力可以防止在健康危机期间出现过多的医院转诊和进一步的死亡。
