美国 7620 例 COVID-19 多发性硬化症患者的特征和治疗结果

K. Ramphul, S. Sombans, R. Verma, P. Lohana, B. Dhillon, Stephanie Gonzalez Mejias, S. Sanikommu, Y. Ramphul, P. K. Pekyi-Boateng
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摘要

在 COVID-19 大流行之初,一些专家对其对多发性硬化症(MS)患者的影响表示担忧。本研究旨在利用美国最大的住院病人数据库提供一个视角。我们通过 2020 年全国住院病人样本 (NIS) 筛选了 2020 年 4 月至 12 月期间的 COVID-19 病例。我们对各种结果进行了分析。我们发现了1628110例COVID-19住院病例,其中包括7620例(0.5%)多发性硬化症患者。8.9%的COVID-19 MS患者死亡,低于非MS病例(12.9%)。患有 COVID-19 的多发性硬化症患者需要无创通气(4.5% 对 6.4%)和机械通气(9.0% 对 11.2%)的比例较低。此外,患有 COVID-19 的多发性硬化症患者如果年龄超过 60 岁、患有慢性肺部疾病 (CPD)、肥胖或糖尿病,则需要无创通气的几率更高。私人保险受益人与医疗保险受益人相比风险更低。同样,对于机械通气,年龄≥60 岁、酗酒、肥胖、糖尿病、高血压或透析患者的几率较高,而女性、吸烟者、抑郁症或高脂血症患者的几率较低。研究显示,年龄≥60 岁、患有 CPD、肥胖症、慢性肾脏病或有过心肌梗死病史的人死亡率较高,而女性、吸烟者、抑郁症患者和高脂血症患者的预后较好。与白人相比,黑人的死亡几率较低,而西班牙裔的死亡几率较高。与医疗保险相比,医疗补助和私人保险患者的死亡几率较低。我们发现,患有 COVID-19 的多发性硬化症和非多发性硬化症患者在特征和预后方面存在一些差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characteristics and Outcomes of 7620 Multiple Sclerosis Patients Admitted With COVID-19 in the United States
At the start of the COVID-19 pandemic, several experts raised concerns about its impact on Multiple Sclerosis (MS) patients. This study aims to provide a perspective using the biggest inpatient database from the United States. We screened for COVID-19 cases between April to December 2020, via the 2020 National Inpatient Sample (NIS). Various outcomes were analyzed. We identified 1,628,110 hospitalizations with COVID-19, including 7620 (.5%) MS patients. 8.9% of MS patients with COVID-19 died, and it was lower than non-MS cases (12.9%). Less MS patients with COVID-19 needed non-invasive ventilation (4.5% vs 6.4%) and mechanical ventilation (9.0% vs 11.2%). Furthermore, MS patients with COVID-19 reported higher odds of non-invasive ventilation if they were ≥60 years, had chronic pulmonary disease (CPD), obesity, or diabetes. Private insurance beneficiaries showed reduced risk, vs Medicare. Similarly, for mechanical ventilation, those ≥60 years, with alcohol abuse, obesity, diabetes, hypertension, or dialysis had higher odds, while females, smokers, and those with depression or hyperlipidemia showed reduced odds. The study revealed higher odds of mortality among those aged ≥60, who had CPD, obesity, CKD, or a history of old MI while females, smokers, as well as those with depression, and hyperlipidemia showed better outcomes. Blacks had lower odds, whereas Hispanics had higher odds of death, vs Whites. Medicaid and Privately insured patients had lower odds of dying vs Medicare. We found several differences in patient characteristics and outcomes among MS and non-MS patients with COVID-19.
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