Sitompul Pompini Agustina, Mariana Nina, Maemun Siti, Widiantari Aninda Dinar, Murtiani Farida, Rosamarlina Rosamarlina, Rusli Adria, Sundari Titi, Purnama Tri Bayu
Pulmonology Department, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia.
Research Department, Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia.
Malays J Med Sci. 2024 Oct;31(5):215-230. doi: 10.21315/mjms2024.31.5.15. Epub 2024 Oct 8.
The increasing mortality rate of COVID-19 has remained an international public health concern. Limited studies on clinical treatment and morbidity in hospital settings are available in Indonesia. This present study aims to analyse demographic characteristics, clinical signs and treatment in COVID-19 patients and their association to the mortality case in Sulianti Saroso Infectious Disease Hospital.
The study applied a retrospective cohort approach to all COVID-19 inpatients confirmed by polymerase chain reaction (PCR) testing in Sulianti Saroso Infectious Disease Hospital from 1 June 2020 to 30 September 2021. Overall survival rates until the end of the study were calculated using the Kaplan-Meier method and compared using the log-rank test. A Cox regression model was used to evaluate the crude and adjusted hazard ratios for associated factors.
We collected 1,970 inpatient data that met our inclusion and exclusion criteria. Most of them were 19 years old-59 years old (73.2%) and male (52.6%), and 966 (49%) patients had comorbidities. Approximately 63.9%, 89.2%, 89.8%, 82%, and 14.1% of the patients had ferritin levels ≤ 800, received antiviral treatment, were treated in non-intensive wards, had a moderate or mild clinical stage and did not survive, respectively. In the adjusted analysis, mortality was associated with sex (hazard ratio [HR]: 1.12; 95% CI: 1.02, 1.23), presence of comorbidity (HR: 1.19; 95% CI: 1.08, 1.30) and favipiravir (FPV) plus azithromycin treatment (HR: 1.21; 95% CI: 1.06,1.39). FPV treatment (HR: 1.35; 95% CI: 1.04, 1.75) was associated with higher mortality.
Tailored approaches to treatment, considering individual risk factors and comorbidities, are crucial in improving patient outcomes.
新型冠状病毒肺炎(COVID-19)死亡率的不断上升一直是国际公共卫生关注的问题。印度尼西亚关于医院环境中临床治疗和发病率的研究有限。本研究旨在分析COVID-19患者的人口统计学特征、临床症状和治疗情况,以及它们与苏利亚蒂·萨罗索传染病医院死亡病例的关联。
本研究采用回顾性队列研究方法,对2020年6月1日至2021年9月30日期间在苏利亚蒂·萨罗索传染病医院通过聚合酶链反应(PCR)检测确诊的所有COVID-19住院患者进行研究。使用Kaplan-Meier方法计算直至研究结束时的总生存率,并使用对数秩检验进行比较。采用Cox回归模型评估相关因素的粗风险比和调整后风险比。
我们收集了1970例符合纳入和排除标准的住院患者数据。其中大多数患者年龄在19岁至59岁之间(73.2%),为男性(52.6%),966例(49%)患者患有合并症。分别约有63.9%、89.2%、89.8%、82%和14.1%的患者铁蛋白水平≤800、接受了抗病毒治疗、在非重症病房接受治疗、处于中度或轻度临床阶段且未存活。在调整分析中,死亡率与性别(风险比[HR]:1.12;95%置信区间:1.02,1.23)、合并症的存在(HR:1.19;95%置信区间:1.08,1.30)以及法匹拉韦(FPV)加阿奇霉素治疗(HR:1.21;95%置信区间:1.06,1.39)相关。FPV治疗(HR:1.35;95%置信区间:1.04,1.75)与较高的死亡率相关。
考虑个体风险因素和合并症的针对性治疗方法对于改善患者预后至关重要。