Clinical Characteristics, Outcomes, and Risk Factors of Patients Hospitalized for COVID-19 across the Latest Pandemic Waves: Has Something Changed?

SPG biomed Pub Date : 2023-05-30 DOI:10.3390/biomed3020024
Mariacristina Poliseno, Edoardo Paolo Drago, M. Poli, M. Altamura, S. Bruno, A. Calamo, A. Giannelli, G. Infante, Michele Mazzola, Damiana Moschetta, S. Lo Caputo, T. Santantonio, S. Carbonara
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引用次数: 1

Abstract

Despite the availability of vaccines and antivirals and the biological evolution of SARS-CoV-2, the rate of hospitalizations and deaths from COVID-19 remains high in Italy. It is crucial to understand whether and how the clinical characteristics of patients hospitalized for COVID-19 have changed over 2021–2022 and which risk factors are currently associated with adverse outcomes to develop targeted interventions. In this study, we present and compare the characteristics and outcomes of 310 patients with COVID-19 who were hospitalized between 1 August and 9 December 2021, when the Delta SARS-CoV-2 variant was prevalent (Group A), and between 3 January and 30 June 2022, when the Omicron variant was predominant (Group B). Using Survival Analysis, we estimated the cumulative 28-day hazard ratio (H.R.) of Intensive Care Unit (ICU) admission/death of patients in Group B vs. A. We built uni- and multivariate Cox regression models for the overall population and each group to identify risk factors for ICU admission/death among patient features. We found that Group B had a comparable risk of ICU admission/death (HR 1.60, 95% Confidence Interval, C.I. 1.00–2.58, p = 0.05) but a higher prevalence of elderly and co-morbid subjects than Group A. Non-invasive ventilation requirement was associated with adverse outcomes in both Group A (HR 21.03, 95% C.I. 5.34–82.80, p < 0.001) and Group B (HR 4.53, 95% C.I. 2.39–8.59, p < 0.001), as well as in the overall population (HR 3.88, 95% C.I. 2.49–6.06, p < 0.001). During the Omicron wave, elderly and co-morbid subjects had the highest risk of hospitalization and poor outcomes.
在最近的大流行浪潮中,COVID-19住院患者的临床特征、结局和危险因素:有什么变化吗?
尽管可以获得疫苗和抗病毒药物,并且了解了SARS-CoV-2的生物进化,但意大利的COVID-19住院率和死亡率仍然很高。了解2019冠状病毒病住院患者的临床特征在2021-2022年期间是否发生了变化以及如何发生变化,以及目前哪些风险因素与不良后果相关,对于制定有针对性的干预措施至关重要。在这项研究中,我们介绍并比较了在2021年8月1日至12月9日期间住院的310名COVID-19患者的特征和结果,当时德尔塔SARS-CoV-2变体普遍(A组),以及在2022年1月3日至6月30日期间住院的Omicron变体主要(B组)。我们估计了B组与a组患者重症监护室(ICU)入院/死亡的累积28天风险比(hr)。我们为总体人群和每一组建立了单因素和多因素Cox回归模型,以确定患者特征中ICU入院/死亡的危险因素。我们发现,B组有一个类似的ICU住院/死亡风险(HR 1.60, 95%置信区间,C.I. 1.00 - -2.58, p = 0.05),但老年人和阶段科目患病率高于a组非侵入式通风的要求是与两组不良预后相关(HR 21.03, 95% C.I. 5.34 - -82.80, p < 0.001)和B组(HR 4.53, 95% C.I. 2.39 - -8.59, p < 0.001),以及在整个人口(HR 3.88, 95% C.I. 2.49 - -6.06, p < 0.001)。在欧米克隆波期间,老年人和合并症患者住院和预后不良的风险最高。
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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