Clinical Characteristics, Risk Factors, and Outcomes Among a Large Midwestern U.S. Cohort of Patients Hospitalized With COVID-19 Prior to Vaccine Availability.

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES
V. Zlochiver, A. P. Perez Moreno, Michael Joseph Peterson, Khalil Odeh, Ashley Mainville, Katherine Busniewski, Jon Wrobel, Mohamed Hommeida, Blair L. Tilkens, P. Sharma, Hluechy X. Vang, Sara Walczak, Fekadesilassie Moges, Kritika Garg, A. J. Tajik, S. Allaqaband, T. Bajwa, M. Jan
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引用次数: 1

Abstract

Purpose The COVID-19 pandemic posed unprecedented demands on health care. This study aimed to characterize COVID-19 inpatients and examine trends and risk factors associated with hospitalization duration, intensive care unit (ICU) admission, and in-hospital mortality. Methods This retrospective study analyzed patients with SARS-CoV-2 infection hospitalized at an integrated health system between February 2, 2020, and December 12, 2020. Patient characteristics and clinical outcomes were obtained from medical records. Backward stepwise logistic regression analyses were used to identify independent risk factors of ICU admission and in-hospital mortality. Cox proportional hazards models were used to evaluate relationships between ICU admission and in-hospital mortality. Results Overall, 9647 patients were analyzed. Mean age was 64.6 ± 18 years. A linear decrease was observed for hospitalization duration (0.13 days/week, R2=0.71; P<0.0001), ICU admissions (0.35%/week, R2=0.44; P<0.001), and hospital mortality (0.16%/week, R2=0.31; P<0.01). Bacterial co-infections, male sex, history of chronic lung and heart disease, diabetes, and Hispanic ethnicity were identified as independent predictors of ICU admission (P<0.001). ICU admission and age of ≥65 years were the strongest independent risk factors associated with in-hospital mortality (P<0.001). The in-hospital mortality rate was 8.3% (27.4% in ICU patients, 2.6% in non-ICU patients; P<0.001). Conclusions Results indicate that, over the pandemic's first 10 months, COVID-19 carried a heavy burden of morbidity and mortality in older patients (>65 years), males, Hispanics, and those with bacterial co-infections and chronic comorbidities. Although disease severity has steadily declined following administration of COVID-19 vaccines along with improved understanding of effective COVID-19 interventions, these study findings reflect a "natural history" for this novel infectious disease in the U.S. Midwest.
在疫苗可用之前,美国中西部住院的COVID-19患者的临床特征、危险因素和结局
目的新冠肺炎大流行对医疗保健提出了前所未有的要求。本研究旨在描述新冠肺炎住院患者的特征,并研究与住院时间、重症监护室(ICU)入院和住院死亡率相关的趋势和风险因素。方法这项回顾性研究分析了2020年2月2日至2020年12月12日期间在综合卫生系统住院的严重急性呼吸系统综合征冠状病毒2型感染患者。从病历中获取患者特征和临床结果。采用后向逐步逻辑回归分析来确定ICU入院和住院死亡率的独立危险因素。Cox比例风险模型用于评估ICU入院和住院死亡率之间的关系。结果共分析9647例患者。平均年龄64.6±18岁。观察到住院时间(0.13天/周,R2=0.71;P65年)、男性、西班牙裔以及细菌合并感染和慢性合并症患者呈线性下降。尽管在接种新冠肺炎疫苗后,疾病严重程度稳步下降,对新冠肺炎有效干预措施的了解也有所提高,但这些研究结果反映了美国中西部这种新型传染病的“自然史”。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Patient-Centered Research and Reviews
Journal of Patient-Centered Research and Reviews HEALTH CARE SCIENCES & SERVICES-
自引率
5.90%
发文量
35
审稿时长
20 weeks
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