Clinical features and their association with death in a large cohort of adult inpatients with COVID-19

Jaime A. Collins, Ángel A. Altamirano, Nadia C. Delgado, José L. Vargas, Manuel J. Cáceres, Gerson E. Díaz, Enrique A. Hernández, Joshuan J. Barboza, Adrián V. Hernández
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Abstract

Objective: To determine the clinical features and their association with death in a large cohort of adult inpatients with COVID-19. Material and Methods: Retrospective cohort study of patients admitted by COVID-19 to the Almenara General Hospital in Lima, Peru, between March and May 2020. Clinical features on admission were evaluated according to death in bivariate and multivariate Cox regression analyses. Results: A total of 533 patients were included (23% women; 55% over 60 years-old; 27% death). Those who died had significantly higher proportions of patients over 60 years, pre-existing diseases, and severe/critical illness compared to alive patients: 73% vs. 44%, p<0.001; 68% vs. 57%, p=0.021; and 46%/34% vs. 28%/16%, p<0.001, respectively. Inbivariate analyses age over 60 years (uHR 2.49, 95%CI: 1.83-3.39), atrial fibrillation (uHR 2.09, 95%CI: 1.03-4.24) and hypothyroidism (uHR 2.75, 95%CI: 1.02-7.45) were associated with death. While in the multivariate analyses age over 60 years (aHR 2.53, 95%CI: 1.81-3.53), obesity (aHR 2.43, 95%CI: 1.44-4.07), chronic renal disease (aHR 2.65, 95%CI: 1.21-5.82) and hypothyroidism (aHR 4.22, 95%CI: 1.47-12.1) were independently associated with higher risk of death. Conclusions: During the first two months of the epidemic, patients admitted by COVID-19 at the Almenara General Hospital were more frequently older men and had a relevant pre-existing disease burden, as well as severe and critical illness. Mortality was high and was associated with older age, obesity, chronic renal disease, and hypothyroidism.
大型成年住院患者COVID-19的临床特征及其与死亡的关系
目的:了解一大批成年COVID-19住院患者的临床特征及其与死亡的关系。材料和方法:对2020年3月至5月期间秘鲁利马阿尔梅纳拉总医院收治的COVID-19患者进行回顾性队列研究。采用双因素和多因素Cox回归分析,评估入院时的临床特征。结果:共纳入533例患者(女性23%;60岁以上的占55%;27%的死亡)。与活着的患者相比,死亡患者中60岁以上患者、既往疾病和严重/危重疾病的比例明显更高:73%对44%,p<0.001;68% vs. 57%, p=0.021;46%/34% vs. 28%/16%, p<分别为0.001。双因素分析显示,年龄超过60岁(uHR 2.49, 95%CI: 1.83-3.39)、房颤(uHR 2.09, 95%CI: 1.03-4.24)和甲状腺功能减退(uHR 2.75, 95%CI: 1.02-7.45)与死亡相关。而在多变量分析中,年龄超过60岁(aHR 2.53, 95%CI: 1.81-3.53)、肥胖(aHR 2.43, 95%CI: 1.44-4.07)、慢性肾脏疾病(aHR 2.65, 95%CI: 1.21-5.82)和甲状腺功能减退(aHR 4.22, 95%CI: 1.47-12.1)与较高的死亡风险独立相关。结论:在疫情发生的前两个月,阿尔梅纳拉总医院收治的COVID-19患者以老年男性居多,且存在相关的既往疾病负担,以及重症和危重症患者。死亡率高,且与老年、肥胖、慢性肾脏疾病和甲状腺功能减退有关。
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