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对有症状的COVID-19急诊科患者中哮喘与临床结局之间的关联进行特征描述。

Characterizing the Association Between Asthma and Clinical Outcomes in Emergency Department Patients With Symptomatic COVID-19.

作者信息

Al Mazloum Bachar, Richardson Harriet, Peng Yingwei, Rowe Brian, Hohl Corinne M, Latiu Vlad, Chadwick Dryden, Chandra Kavish, Brooks Steven C

机构信息

Department of Public Health Sciences, Queen's University, Kingston, CAN.

Department of Public Health Sciences, Divisions of Cancer Care and Epidemiology and Canadian Cancer Trials Group, Cancer Research Institute, Queen's University, Kingston, CAN.

出版信息

Cureus. 2025 Feb 25;17(2):e79657. doi: 10.7759/cureus.79657. eCollection 2025 Feb.

Abstract

Few studies have investigated the risks of developing intubation and death in patients seen in the emergency department (ED) with COVID-19 and pre-existing asthma. We conducted a retrospective cohort study using data from the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) from March 1st, 2020, to December 31st, 2021. Inclusion criteria were age ≥18 and a positive SARS-CoV-2 test. The primary outcome was a composite of intubation or death, and the secondary outcome was severe COVID-19, as defined by the World Health Organization. Multivariable modified Poisson regression was used to assess the association between asthma and outcomes, adjusted for possible confounding. Out of 38,139 patients, 2,826 (7.41%) had asthma, and 17.1% were using inhaled corticosteroids (ICS). The study found no significant evidence suggesting an association between asthma and intubation or death in the hospital (relative risk (RR): 0.97; 95% CI: 0.86-1.1). The highest risk group for the primary outcome was patients aged 80+ years (RR: 10.54; 95% CI: 7.01-15.85), compared to the reference group 18-29 years. Users of ICS agents had a slightly higher risk of the primary outcome compared to non-ICS users (RR: 1.12; 95% CI: 1.01-1.25).

摘要

很少有研究调查急诊科(ED)中患有2019冠状病毒病(COVID-19)和既往哮喘的患者发生插管和死亡的风险。我们进行了一项回顾性队列研究,使用了来自加拿大COVID-19急诊科快速反应网络(CCEDRRN)2020年3月1日至2021年12月31日的数据。纳入标准为年龄≥18岁且严重急性呼吸综合征冠状病毒2(SARS-CoV-2)检测呈阳性。主要结局是插管或死亡的复合结局,次要结局是世界卫生组织定义的重症COVID-19。采用多变量修正泊松回归评估哮喘与结局之间的关联,并对可能的混杂因素进行了调整。在38139名患者中,2826名(7.41%)患有哮喘,17.1%正在使用吸入性糖皮质激素(ICS)。该研究没有发现显著证据表明哮喘与住院期间的插管或死亡之间存在关联(相对风险(RR):0.97;95%置信区间:0.86-1.1)。主要结局的最高风险组是80岁及以上的患者(RR:10.54;95%置信区间:7.01-15.85),与18-29岁的参照组相比。与非ICS使用者相比,ICS使用者发生主要结局的风险略高(RR:1.12;95%置信区间:1.01-1.25)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/061d/11949855/cd38edf654ba/cureus-0017-00000079657-i01.jpg

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