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COVID-19 相关与其他呼吸道病毒导致的 AECOPD 患者的临床特征和结局。

Clinical Characteristics and Outcomes of Hospitalized AECOPDs Secondary to SARS-CoV-2 versus Other Respiratory Viruses.

机构信息

Monash Lung, Sleep, Allergy & Immunology, Monash Health, Melbourne, Victoria, Australia.

Department of General Medicine, Monash Health, Melbourne, Victoria, Australia.

出版信息

Int J Chron Obstruct Pulmon Dis. 2024 Nov 14;19:2421-2430. doi: 10.2147/COPD.S479968. eCollection 2024.

Abstract

OBJECTIVE

To compare clinical characteristics and outcomes of hospitalized acute exacerbations of COPD (AECOPD)s secondary to SARS-CoV-2 versus other respiratory viruses amongst a highly vaccinated population in the Omicron era.

DESIGN

Retrospective cohort study; analysis of hospital medical records and linked pathology and radiology reports.

SETTING

Tertiary health network in Victoria, Australia; January 2022-August 2022.

MAIN OUTCOME MEASURES

Key clinical information including comorbidities, vaccination status, treatments administered and outcomes such as hospital length of stay, ICU admission, non-invasive ventilation usage and inpatient mortality.

RESULTS

One hundred ninety-nine viral AECOPDs - 125 SARS-CoV-2 and 74 other viruses were identified. Of the SARS-CoV-2 group. 13.6% were unvaccinated, 17.6% partially and 68.0% fully vaccinated. The SARS-CoV-2 group were older (77.2 vs 68.9, p < 0.00001) with more comorbidities (1[1-2] vs 1[0-2], p = 0.008) and lower candidacy for full resuscitation (25.6% vs 56.8%, p < 0.0001). Mortality tended to be higher among SARS-CoV2 admission (9.6% v 2.7%, p = 0.066) but rates of ICU admission (10.4% v 13.5%, p = 0.507), length of hospitalisation (5[3-8] vs 5[3-9], p = 0.9) and readmission within 30 days (25% vs 33.3%, p = 0.184) were similar.

CONCLUSION

In a highly vaccinated population in the Omicron era, COPD patients requiring hospitalisation with SARS-CoV-2 are older with more comorbidities than those admitted with other respiratory viruses. Length of hospitalisation and ICU utilisation was similar. Inpatient mortality may be higher.

摘要

目的

在奥密克戎时代,比较接种率高的人群中因 SARS-CoV-2 与其他呼吸道病毒导致的住院急性加重期慢阻肺(AECOPD)的临床特征和结局。

设计

回顾性队列研究;对医院病历和相关病理及影像学报告进行分析。

地点

澳大利亚维多利亚州的一个三级医疗网络;2022 年 1 月至 2022 年 8 月。

主要观察指标

包括合并症、疫苗接种情况、治疗措施以及住院时间、入住 ICU、无创通气使用和住院死亡率等结局在内的关键临床信息。

结果

共发现 199 例病毒性 AECOPD,其中 125 例为 SARS-CoV-2,74 例为其他病毒。SARS-CoV-2 组中,未接种疫苗者占 13.6%,部分接种疫苗者占 17.6%,完全接种疫苗者占 68.0%。SARS-CoV-2 组患者年龄更大(77.2 岁比 68.9 岁,p<0.00001),合并症更多(1[1-2] 比 1[0-2],p=0.008),完全复苏的可能性更低(25.6%比 56.8%,p<0.0001)。SARS-CoV-2 入院患者的死亡率较高(9.6%比 2.7%,p=0.066),但 ICU 入院率(10.4%比 13.5%,p=0.507)、住院时间(5[3-8] 天比 5[3-9] 天,p=0.9)和 30 天内再入院率(25%比 33.3%,p=0.184)相似。

结论

在奥密克戎时代,需要住院治疗的 SARS-CoV-2 导致的 AECOPD 患者比因其他呼吸道病毒导致的 AECOPD 患者年龄更大,合并症更多。住院时间和 ICU 使用情况相似。住院死亡率可能更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebf9/11572465/252cb23a4238/COPD-19-2421-g0001.jpg

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