Section of Infectious Diseases, Taipei City Hospital, Heping Fuyou Branch Branch, Taipei, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
BMC Infect Dis. 2024 Aug 20;24(1):840. doi: 10.1186/s12879-024-09654-w.
This cohort study determines the predictors for cause-specific and timing of deaths in patients with COVID-19 in Taiwan.
Patients with laboratory-confirmed COVID-19 admitted to Taipei City Hospital from January 1 to July 31, 2022, were recruited in this cohort. All patients were followed up until death, discharge from the hospital, or August 31, 2022. Early deaths within the first 2 weeks were recorded, and the cause of death was confirmed by the death certificate database of Taiwan. Predictors of cause-specific and timing of deaths of patients with COVID-19 were determined using multinomial Cox proportional hazards regression analysis.
Of the 195 (8.0%) patients who died during hospitalization, 147 (84.0%) had COVID-19-specific deaths. Moreover, 54.9% of the deceased patients had early death. After controlling for other covariates, patients aged ≥ 65 years had a higher risk of COVID-19-specific, non-COVID-19-specific, early, and late deaths [adjusted hazards ratio (AHR): 3.85, 6.45, 3.33, and 6.57; 95% confidence interval (CI): 1.91-7.78, 1.17-35.68, 1.51-7.36, and 2.18-19.76, respectively]. Fully vaccinated patients had a lower risk of COVID-19-specific (AHR: 0.68; 95% CI: 0.47-0.98) and early deaths (AHR: 0.54; 95% CI: 0.35-0.84), whereas comorbid patients with chronic obstructive pulmonary disease had a higher risk of non-COVID-19-specific deaths (AHR: 5.43; 95% CI: 1.73-17.03).
This study suggests that prioritizing COVID-19 vaccination and carefully monitoring comorbid patients during hospitalization can reduce the risk of COVID-19-specific and early deaths and non-COVID-19-specific mortalities, respectively.
本队列研究旨在确定台湾 COVID-19 患者的特定病因和死亡时间的预测因素。
本研究纳入了 2022 年 1 月 1 日至 7 月 31 日期间因实验室确诊 COVID-19 而入住台北市立医院的患者。所有患者均随访至死亡、出院或 2022 年 8 月 31 日。记录了 2 周内的早期死亡，并通过台湾死亡证明数据库确认死因。采用多项 Cox 比例风险回归分析确定 COVID-19 患者特定病因和死亡时间的预测因素。
在住院期间死亡的 195 例（8.0%）患者中，147 例（84.0%）死于 COVID-19 特异性疾病。此外，54.9%的死亡患者发生早期死亡。在控制其他混杂因素后，年龄≥65 岁的患者 COVID-19 特异性死亡、非 COVID-19 特异性死亡、早期死亡和晚期死亡的风险更高[校正风险比（AHR）：3.85、6.45、3.33 和 6.57；95%置信区间（CI）：1.91-7.78、1.17-35.68、1.51-7.36 和 2.18-19.76]。完全接种疫苗的患者 COVID-19 特异性死亡（AHR：0.68；95%CI：0.47-0.98）和早期死亡（AHR：0.54；95%CI：0.35-0.84）的风险较低，而合并慢性阻塞性肺疾病的患者非 COVID-19 特异性死亡的风险较高（AHR：5.43；95%CI：1.73-17.03）。
本研究表明，优先接种 COVID-19 疫苗并在住院期间密切监测合并症患者，可分别降低 COVID-19 特异性和早期死亡以及非 COVID-19 特异性死亡率的风险。
