2020年住院的COVID-19康复患者出院后的全因死亡率:慢性肾病的影响

Guilherme Schittine Bezerra Lomba, Pedro Henrique Abreu da Silva, N. F. Rosário, Thalia Medeiros, L. Alves, Andrea Alice Silva, Jorge Reis Almeida, J. Lugon
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摘要

摘要 在巴西,COVID-19 造成了巨大的负担,与较高住院死亡率相关的风险因素已被广泛研究。然而,有关急性 SARS-CoV-2 感染住院期间存活患者的短期全因死亡率和死亡相关因素的信息却很有限。我们分析了巴西一个中心的 COVID-19 患者住院后六个月的死亡率和可能的风险因素。这是一项回顾性队列研究,重点是六个月的随访。排除标准为住院期间死亡、转院和年龄小于 18 岁。我们从 2020 年 3 月至 2020 年 12 月期间所有经 RT-PCR 检测 SARS-CoV-2 呈阳性的住院患者的病历中收集了数据,因此样本量为 106 例患者。主要结果是住院后死亡,而合并症和人口统计学特征则作为风险因素进行评估。住院后的粗死亡率为 16%。随访的前30天死亡率最高。在住院后死亡率的 Cox 回归模型中,既往患有慢性肾病(HR,4.06,95%CI 1.46 - 11.30)和住院时间较长(HR 1.01,95%CI 1.00 - 1.02)是唯一与死亡有统计学关联的因素。总之,观察到的六个月全因死亡率较高。在六个月的随访中,观察到曾患有慢性肾脏病和住院时间较长的患者死亡风险较高。这些发现强调了在此期间加强医疗监控的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Post-discharge all-cause mortality in COVID-19 recovered patients hospitalized in 2020: the impact of chronic kidney disease
ABSTRACT In Brazil, the COVID-19 burden was substantial, and risk factors associated with higher in-hospital mortality rates have been extensively studied. However, information on short-term all-cause mortality and the factors associated with death in patients who survived the hospitalization period of acute SARS-CoV-2 infection is limited. We analyzed the six-month post-hospitalization mortality rate and possible risk factors of COVID-19 patients in a single center in Brazil. This is a retrospective cohort study focused on a six-month follow-up. The exclusion criteria were death during hospitalization, transference to another hospital, and age under 18. We collected data from the charts of all hospitalized patients from March 2020 to December 2020 with a positive RT-PCR test for SARS-CoV-2, resulting in a sample size of 106 patients. The main outcome was death after hospitalization, whereas comorbidities and demographics were evaluated as risk factors. The crude post-hospitalization death rate was 16%. The first 30 days of follow-up had the highest mortality rate. In a Cox regression model for post-hospitalization mortality, previous chronic kidney disease (HR, 4.06, 95%CI 1.46 – 11.30) and longer hospital stay (HR 1.01, 95%CI 1.00 – 1.02) were the only factors statistically associated with death. In conclusion, a high six-month all-cause mortality was observed. Within the six-month follow-up, a higher risk of death was observed for patients who had prior CKD and longer hospital stay. These findings highlight the importance of more intensive medical surveillance during this period.
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