Chang Yu-Hui, Burton Whitney, Nguyen Phung-Anh, Khang Do Duy, Chen Chang-I, Huang Chung-Chien, Lam Carlos Shu-Kei, Lin Wen-Kuang, Wang Fu-Der, Phuc Phan Thanh, Lu Christine Y, Lee Hsin-Lun, Hsu Min-Huei, Huang Chih-Wei, Yang Hsuan-Chia, Lin Shiue-Ming, Yang Chieh, Hsu Jason C
School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.
International Ph.D. Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan.
J Glob Health. 2025 Sep 5;15:04236. doi: 10.7189/jogh.15.04236.
As the global battle against COVID-19 continues, understanding the factors contributing to severe outcomes remains critical for public health strategies. We aim to identify the determinants significantly influencing severe COVID-19 infection and mortality among the general population in Taiwan.
We conducted a retrospective cohort study using data extracted from the Taipei Medical University Clinical Research Database from 1 January 2022 to 31 December 2022. We defined the primary outcomes as severe COVID-19 infection, including hospitalisation, ventilator use, intubation, and mortality. We performed logistic regression analyses to explore the association of various factors, including demographic characteristics, body mass index (BMI), Charlson Comorbidity Index score, and multiple comorbidities.
Among 96 489 confirmed COVID-19 cases, 44 996 (46.6%) were classified as high-risk patients. Compared to females, male patients had significantly higher risks of ventilator use (odds ratio (OR) = 1.245; 95% confidence interval (CI) = 1.147-1.352, P < 0.0001), intubation (OR = 1.115; 95% CI = 1.011-1.230, P = 0.03), and mortality (OR = 1.510; 95% CI = 1.332-1.713, P < 0.0001). Patients with lower BMI had significantly increased risks of ventilator use (OR = 0.972; 95% CI = 0.964-0.981, P < 0.0001) and mortality (OR = 0.92; 95% CI = 0.908-0.935, P < 0.0001), compared to patients with higher BMI. Patients with chronic comorbidities such as heart disease, moderate to severe kidney disease, diabetes, cancer, hypertension, anaemia, and Parkinson disease had significantly higher risks of severe COVID-19 or mortality compared to those without these conditions. Conversely, patients with peptic ulcer disease or hyperlipidaemia seem to have lower risks of severity and mortality compared to those without these conditions.
We found that being male, having a lower BMI, and having certain chronic conditions increased the risk of severe COVID-19 outcomes, while peptic ulcer disease and hyperlipidaemia were linked to reduced risks. These findings highlight the need for targeted public health strategies for high-risk groups.
随着全球抗击新冠疫情的持续，了解导致严重后果的因素对于公共卫生策略仍至关重要。我们旨在确定显著影响台湾普通人群中新冠严重感染和死亡的决定因素。
我们进行了一项回顾性队列研究，使用从台北医学大学临床研究数据库中提取的2022年1月1日至2022年12月31日的数据。我们将主要结局定义为新冠严重感染，包括住院、使用呼吸机、插管和死亡。我们进行了逻辑回归分析，以探讨各种因素的关联，包括人口统计学特征、体重指数（BMI）、查尔森合并症指数评分和多种合并症。
在96489例确诊的新冠病例中，44996例（46.6%）被归类为高危患者。与女性相比，男性患者使用呼吸机的风险显著更高（优势比（OR）=1.245；95%置信区间（CI）=1.147-1.352，P<0.0001）、插管风险（OR=1.115；95%CI=1.011-1.230，P=0.03）和死亡风险（OR=1.510；95%CI=1.332-1.713，P<0.0001）。与BMI较高的患者相比，BMI较低的患者使用呼吸机的风险（OR=0.972；95%CI=0.964-0.981，P<0.0001）和死亡风险（OR=0.92；95%CI=0.908-0.935，P<0.0001）显著增加。患有心脏病、中重度肾病、糖尿病、癌症、高血压、贫血和帕金森病等慢性合并症的患者，与没有这些疾病的患者相比，发生新冠严重感染或死亡的风险显著更高。相反，与没有消化性溃疡疾病或高脂血症的患者相比，患有这些疾病的患者似乎发生严重感染和死亡的风险较低。
我们发现，男性、BMI较低以及患有某些慢性疾病会增加新冠严重后果的风险，而消化性溃疡疾病和高脂血症与风险降低有关。这些发现凸显了针对高危人群制定有针对性的公共卫生策略的必要性。
