不同 COVID-19 变体的长期死亡率：18 个月随访

Q3 Medicine

Russian Journal of Cardiology Pub Date : 2023-12-20 DOI:10.15829/1560-4071-2023-5672

I. Lakman, D. Gareeva, L. Sadikova, A. A. Agapitov, P. Davtyan, V. L. Kayumova, V. Timiryanova, N. Zagidullin

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引用次数: 0

摘要

2019年冠状病毒感染病毒感染和大流行（COVID-19）不仅具有高发病率和院内死亡率的特点，而且出院后患者的死亡率也有所上升。与此同时，2020 年至 2023 年不同大流行波次之间的住院率、患者并发症数量和死亡率以及死亡率也存在差异。比较三种 COVID-19 变种（Alpha、Delta 和 Omicron）患者住院后 18 个月的死亡率。在这项前瞻性、单中心、非随机连续研究中，分析了 2400 名阿尔法变体（2020 年）、1826 名德尔塔变体（2021 年）和 997 名奥米克隆变体（2022 年）患者的医疗记录。终点是随访期间的全因死亡率。COVID-19菌株的临床和人口统计学特征存在以下差异：在德尔塔波和欧米克隆波中，更多女性住院；在欧米克隆波中，患者年龄更大。此外，Delta 和 Omicron 变体的合并症患者（慢性阻塞性肺病、高血压和心力衰竭）多于 Alpha 变体，但慢性肾病在 Alpha 和 Omicron 变体中更为常见。两组患者的死亡率差异很大，Delta 型最高，Omicron 型最低，Delta 型的最高死亡率出现在出院后的头 90 天。在12至18个月期间，Delta波住院患者的存活率下降最多，这是由长期心血管后果的风险决定的。不同COVID-19变体患者的临床和人口统计学差异，以及不同波段患者死亡率的显著差异，都强调了个性化治疗和长期住院后监测的重要性。

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Long-term mortality in different COVID-19 variants: 18-month follow-up

The viral infection and pandemic of coronavirus infection 2019 (COVID-19) was characterized not only by high morbidity and in-hospital mortality, but also by an increase in the mortality of patients after hospital discharge. At the same time, differences were noted in hospitalization rate, the number of complications and mortality of patients, and mortality rate between different pandemic waves from 2020 to 2023.Aim. To compare the 18-month post-hospital mortality rate of patients between three COVID-19 variants (Alpha, Delta and Omicron).Material and methods. In this prospective, single-center, non-randomized continuous study, 2400 medical records of patients with the Alpha variant (2020), 1826 with the Delta variant (2021) and 997 with the Omicron variant (2022) were analyzed. The end point was all-cause mortality during the follow-up period.Results. There were following differences in clinical and demographic characteristics in the context of COVID-19 strains: more women were hospitalized in the Delta and Omicron waves; in the Omicron wave, patients were older. Also, comorbid patients were more common with the Delta and Omicron variants than with the Alpha (in chronic obstructive pulmonary disease, hypertension and heart failure), but chronic kidney disease was more common with the Alpha and Omicron variants. The groups differed significantly in mortality, with the maximum being with Delta and the minimum with Omicron, and the maximum mortality with Delta was observed in the first 90 days after discharge. Between 12 and 18 months, survival estimates decreased most for patients hospitalized in the Delta wave, which is determined by the risk of long-term cardiovascular consequences.Conclusion. Clinical and demographic differences between patients with different COVID-19 variants, as well as a significant difference in the mortality rate of patients of different waves, emphasize the importance of a personalized approach to treatment and long-term post-hospital monitoring.

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来源期刊

Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.20

自引率

0.00%

发文量

185

审稿时长

1 months

期刊介绍： Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.