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刚果民主共和国恩加利马诊所前四波新冠疫情期间新冠患者的临床特征及死亡率趋势

Clinical Characteristics and Mortality Trends Among COVID-19 Patients During the First Four Waves in Ngaliema Clinic, Democratic Republic of the Congo.

作者信息

Bepouka Ben, Mandina Madone, Mvibudulu Daniel, Matangila Junior, Okamba Armand, Muyeke Gertrude, Tawaba Dieudonne, Mayasi Nadine, Odio Ossam, Mangala Donat, Lukiana Tuna, Mbula Marcel, Situakibanza Hippolyte, Longokolo Murielle

机构信息

Infectious and Tropical Diseases Service, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo.

Office of Infectious Diseases and Global Health Research, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo.

出版信息

Infect Drug Resist. 2025 May 14;18:2525-2536. doi: 10.2147/IDR.S499371. eCollection 2025.

Abstract

BACKGROUND

COVID-19 disease has been a deadly pandemic in different waves in the Democratic Republic of Congo. However, knowledge of the clinical characteristics of COVID-19 patients and the factors associated with death during different waves is important.

METHODS

We conducted a retrospective cohort of 410 patients hospitalized during 4 waves of COVID-19, from March 20, 2020, to January 2, 2022, at the Ngaliema clinic in DR Congo. We included any patient hospitalized for COVID-19 with biological confirmation by RT-PCR. Factors associated with death were investigated using logistic regression.

RESULTS

During the 4 waves of the COVID-19 pandemic at Clinique Ngaliema, complaints on admission were most often fever, cough and physical asthenia. Death was most common in the elderly, hypertensive and diabetic patients, those with elevated CRP and hyper leukocytosis. Mortality was highest in the 1st wave (28%), followed by the 3rd wave (27%), then the 2nd (22%) and 4th waves (21%). Factors associated with death were hyper leukocytosis (ORa: 2.76; CI 95%: 1.25-6.1), severe disease stage (ORa 21.24; CI 95%: 1.87-24). Vitamin C 500 mg twice a day use was protective (ORa: 0.24; CI 95%: 0.08-0.72).

CONCLUSION

COVID-19 disease poses a real public health problem, with non-negligible mortality. Factors associated with death were degree of disease severity, hyper leukocytosis and non-use of vitamin C. Taking these factors into account will help clinicians and decision-makers to anticipate future waves of the pandemic.

摘要

背景

在刚果民主共和国,新冠疫情以不同浪潮的形式肆虐,造成了严重的人员伤亡。了解新冠患者在不同浪潮中的临床特征以及与死亡相关的因素至关重要。

方法

我们对2020年3月20日至2022年1月2日期间在刚果民主共和国恩加利马诊所因新冠疫情4次浪潮而住院的410名患者进行了回顾性队列研究。我们纳入了任何经逆转录聚合酶链反应(RT-PCR)生物学确诊为新冠的住院患者。使用逻辑回归分析与死亡相关的因素。

结果

在恩加利马诊所的新冠疫情4次浪潮期间,入院时的主诉最常见的是发热、咳嗽和身体乏力。死亡在老年人、高血压和糖尿病患者、C反应蛋白升高和白细胞增多的患者中最为常见。死亡率在第一波最高(28%),其次是第三波(27%),然后是第二波(22%)和第四波(21%)。与死亡相关的因素是白细胞增多(优势比:2.76;95%置信区间:1.25-6.1)、疾病严重阶段(优势比21.24;95%置信区间:1.87-24)。每天两次使用500毫克维生素C具有保护作用(优势比:0.24;95%置信区间:0.08-0.72)。

结论

新冠疫情构成了一个切实的公共卫生问题,死亡率不可忽视。与死亡相关的因素是疾病严重程度、白细胞增多和未使用维生素C。考虑这些因素将有助于临床医生和决策者预测未来的疫情浪潮。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba3c/12085894/a86e2affaf88/IDR-18-2525-g0001.jpg

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