与因严重呼吸系统疾病(SRI)需要住院治疗的12岁及以上患者死亡率相关的因素:2022-2023年肯尼亚和马里COVID-19疫苗有效性评估结果

Brian O Onyando, Bryan O Nyawanda, Daniel Onguru, Fadima C Haidara, Collins Okello, Raphael O Anyango, Ian K Orege, Sidney Ogolla, Billy Ogwel, Alex O Awuor, Samuel Kadivane, Philip Ngere, Carolyne Nasimiyu, Eric Osoro, M Kariuki Njenga, Victor Akelo, Amos Otedo, Shirley Lidechi, John B Ochieng, Nancy A Otieno, Erick M O Muok, Kibet Sergon, Archibald Kwame Worwui, Goitom G Weldegebriel, Isabel Bergeri, Cohuet Sandra, Celine Gurry, J Pekka Nuorti, Patrick Amoth, Rose Jalang'o, Jason M Mwenda, Richard Omore, Samba O Sow
{"title":"与因严重呼吸系统疾病(SRI)需要住院治疗的12岁及以上患者死亡率相关的因素:2022-2023年肯尼亚和马里COVID-19疫苗有效性评估结果","authors":"Brian O Onyando, Bryan O Nyawanda, Daniel Onguru, Fadima C Haidara, Collins Okello, Raphael O Anyango, Ian K Orege, Sidney Ogolla, Billy Ogwel, Alex O Awuor, Samuel Kadivane, Philip Ngere, Carolyne Nasimiyu, Eric Osoro, M Kariuki Njenga, Victor Akelo, Amos Otedo, Shirley Lidechi, John B Ochieng, Nancy A Otieno, Erick M O Muok, Kibet Sergon, Archibald Kwame Worwui, Goitom G Weldegebriel, Isabel Bergeri, Cohuet Sandra, Celine Gurry, J Pekka Nuorti, Patrick Amoth, Rose Jalang'o, Jason M Mwenda, Richard Omore, Samba O Sow","doi":"10.1016/j.vaccine.2025.126910","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mortality attributed to respiratory illnesses is well characterized in children <5 years. However, there is paucity of data among older populations. Here, we leveraged data from the COVID-19 Vaccine Effectiveness Evaluation to establish the factors associated with mortality among patients with severe respiratory illness (SRI) in Kenya and Mali.</p><p><strong>Methods: </strong>We enrolled patients (≥ 12 years) requiring hospitalization for SRI, defined as acute onset (≤ 14 days) of at least two of the following: cough, fever (reported/measured temperature of ≥38 °C), chills, rigors, myalgia, headache, sore throat, fatigue, congestion or runny nose, loss of taste or smell, or pneumonia diagnosis, from referral hospitals in Kenya and Mali. We collected demographic, clinical characteristics of the patients, and nasopharyngeal and oropharyngeal specimens for SARS-CoV-2 testing using RT-PCR. A mixed-effects logistic regression model was fitted to identify factors associated with 30-day mortality among patients with SRI.</p><p><strong>Results: </strong>Between July 2022 and October 2023 9947 SRI patients were enrolled, of whom 9743 were included in this analysis and 1620 (16.6 %) died (Kenya: 1533/7822 [20.0 %]; Mali: 87/1921 [4.5 %]). Compared to patients aged 12-24 years, those aged >64 years were more likely to die (adjusted Odds Ratio [aOR] = 2.36; 95 % Confidence Interval [95 % CI] 1.72-3.24). Patients who were in coma (aOR = 3.45; 95 %CI 2.27-5.24) or Intensive Care Unit (aOR = 2.98; 95 %CI 2.06-4.31), or had HIV infection (aOR = 2.47; 95 %CI 2.11-2.90), liver disease (aOR = 2.42; 95 %CI 1.57-3.74), cancer (aOR = 2.09; 95 %CI 1.46-2.99) or SARS-CoV-2 infected (aOR = 1.24; 95 %CI 1.02-1.52) were at increased risk of death. Additionally, diarrhea, malaise/fatigue, difficulty in breathing, confusion, mechanical ventilation, vasopressor support, malnutrition and admission to High Dependency Unit had significant associations.</p><p><strong>Conclusion: </strong>Mortality was heightened among SRI patients who were older, required critical care, had chronic conditions and infected with SARS-CoV-2 suggesting need for early identification of these conditions to improve possible treatment outcomes.</p>","PeriodicalId":94264,"journal":{"name":"Vaccine","volume":" ","pages":"126910"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors associated with mortality among patients aged 12 years and above requiring hospitalization for severe respiratory illness (SRI): Findings from the COVID-19 vaccine effectiveness evaluation in Kenya and Mali, 2022-2023.\",\"authors\":\"Brian O Onyando, Bryan O Nyawanda, Daniel Onguru, Fadima C Haidara, Collins Okello, Raphael O Anyango, Ian K Orege, Sidney Ogolla, Billy Ogwel, Alex O Awuor, Samuel Kadivane, Philip Ngere, Carolyne Nasimiyu, Eric Osoro, M Kariuki Njenga, Victor Akelo, Amos Otedo, Shirley Lidechi, John B Ochieng, Nancy A Otieno, Erick M O Muok, Kibet Sergon, Archibald Kwame Worwui, Goitom G Weldegebriel, Isabel Bergeri, Cohuet Sandra, Celine Gurry, J Pekka Nuorti, Patrick Amoth, Rose Jalang'o, Jason M Mwenda, Richard Omore, Samba O Sow\",\"doi\":\"10.1016/j.vaccine.2025.126910\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Mortality attributed to respiratory illnesses is well characterized in children <5 years. However, there is paucity of data among older populations. Here, we leveraged data from the COVID-19 Vaccine Effectiveness Evaluation to establish the factors associated with mortality among patients with severe respiratory illness (SRI) in Kenya and Mali.</p><p><strong>Methods: </strong>We enrolled patients (≥ 12 years) requiring hospitalization for SRI, defined as acute onset (≤ 14 days) of at least two of the following: cough, fever (reported/measured temperature of ≥38 °C), chills, rigors, myalgia, headache, sore throat, fatigue, congestion or runny nose, loss of taste or smell, or pneumonia diagnosis, from referral hospitals in Kenya and Mali. We collected demographic, clinical characteristics of the patients, and nasopharyngeal and oropharyngeal specimens for SARS-CoV-2 testing using RT-PCR. A mixed-effects logistic regression model was fitted to identify factors associated with 30-day mortality among patients with SRI.</p><p><strong>Results: </strong>Between July 2022 and October 2023 9947 SRI patients were enrolled, of whom 9743 were included in this analysis and 1620 (16.6 %) died (Kenya: 1533/7822 [20.0 %]; Mali: 87/1921 [4.5 %]). Compared to patients aged 12-24 years, those aged >64 years were more likely to die (adjusted Odds Ratio [aOR] = 2.36; 95 % Confidence Interval [95 % CI] 1.72-3.24). Patients who were in coma (aOR = 3.45; 95 %CI 2.27-5.24) or Intensive Care Unit (aOR = 2.98; 95 %CI 2.06-4.31), or had HIV infection (aOR = 2.47; 95 %CI 2.11-2.90), liver disease (aOR = 2.42; 95 %CI 1.57-3.74), cancer (aOR = 2.09; 95 %CI 1.46-2.99) or SARS-CoV-2 infected (aOR = 1.24; 95 %CI 1.02-1.52) were at increased risk of death. Additionally, diarrhea, malaise/fatigue, difficulty in breathing, confusion, mechanical ventilation, vasopressor support, malnutrition and admission to High Dependency Unit had significant associations.</p><p><strong>Conclusion: </strong>Mortality was heightened among SRI patients who were older, required critical care, had chronic conditions and infected with SARS-CoV-2 suggesting need for early identification of these conditions to improve possible treatment outcomes.</p>\",\"PeriodicalId\":94264,\"journal\":{\"name\":\"Vaccine\",\"volume\":\" \",\"pages\":\"126910\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vaccine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.vaccine.2025.126910\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vaccine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.vaccine.2025.126910","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:呼吸道疾病导致的死亡率在儿童中有很好的特征。方法:我们招募了需要因SRI住院治疗的患者(≥12岁),定义为急性发作(≤14天)至少出现以下两种症状:咳嗽、发烧(报告/测量温度≥38°C)、寒战、僵硬、肌痛、头痛、喉咙痛、疲劳、充血或流鼻涕、味觉或嗅觉丧失,或诊断为肺炎,来自肯尼亚和马里的转诊医院。我们收集了患者的人口学、临床特征以及鼻咽和口咽标本,采用RT-PCR进行SARS-CoV-2检测。采用混合效应logistic回归模型确定与SRI患者30天死亡率相关的因素。结果:在2022年7月至2023年10月期间,9947例SRI患者入组,其中9743例纳入本分析,1620例(16.6%)死亡(肯尼亚:1533/7822例[20.0%];马里:87/1921[4.5%])。与12-24岁的患者相比,bb0 - 64岁的患者死亡的可能性更大(校正优势比[aOR] = 2.36;95%置信区间[95% CI] 1.72-3.24)。昏迷患者(aOR = 3.45;95% CI 2.27-5.24)或重症监护病房(aOR = 2.98;95% CI 2.06-4.31),或有HIV感染(aOR = 2.47;95% CI 2.11-2.90),肝脏疾病(aOR = 2.42;95% CI 1.57-3.74),癌症(aOR = 2.09;95% CI 1.46-2.99)或SARS-CoV-2感染(aOR = 1.24;95% CI 1.02-1.52)死亡风险增加。此外,腹泻、不适/疲劳、呼吸困难、意识不清、机械通气、血管加压剂支持、营养不良和入住高依赖病房也有显著关联。结论:年龄较大、需要重症监护、患有慢性疾病和感染SARS-CoV-2的SRI患者的死亡率较高,这表明需要早期识别这些疾病,以改善可能的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors associated with mortality among patients aged 12 years and above requiring hospitalization for severe respiratory illness (SRI): Findings from the COVID-19 vaccine effectiveness evaluation in Kenya and Mali, 2022-2023.

Background: Mortality attributed to respiratory illnesses is well characterized in children <5 years. However, there is paucity of data among older populations. Here, we leveraged data from the COVID-19 Vaccine Effectiveness Evaluation to establish the factors associated with mortality among patients with severe respiratory illness (SRI) in Kenya and Mali.

Methods: We enrolled patients (≥ 12 years) requiring hospitalization for SRI, defined as acute onset (≤ 14 days) of at least two of the following: cough, fever (reported/measured temperature of ≥38 °C), chills, rigors, myalgia, headache, sore throat, fatigue, congestion or runny nose, loss of taste or smell, or pneumonia diagnosis, from referral hospitals in Kenya and Mali. We collected demographic, clinical characteristics of the patients, and nasopharyngeal and oropharyngeal specimens for SARS-CoV-2 testing using RT-PCR. A mixed-effects logistic regression model was fitted to identify factors associated with 30-day mortality among patients with SRI.

Results: Between July 2022 and October 2023 9947 SRI patients were enrolled, of whom 9743 were included in this analysis and 1620 (16.6 %) died (Kenya: 1533/7822 [20.0 %]; Mali: 87/1921 [4.5 %]). Compared to patients aged 12-24 years, those aged >64 years were more likely to die (adjusted Odds Ratio [aOR] = 2.36; 95 % Confidence Interval [95 % CI] 1.72-3.24). Patients who were in coma (aOR = 3.45; 95 %CI 2.27-5.24) or Intensive Care Unit (aOR = 2.98; 95 %CI 2.06-4.31), or had HIV infection (aOR = 2.47; 95 %CI 2.11-2.90), liver disease (aOR = 2.42; 95 %CI 1.57-3.74), cancer (aOR = 2.09; 95 %CI 1.46-2.99) or SARS-CoV-2 infected (aOR = 1.24; 95 %CI 1.02-1.52) were at increased risk of death. Additionally, diarrhea, malaise/fatigue, difficulty in breathing, confusion, mechanical ventilation, vasopressor support, malnutrition and admission to High Dependency Unit had significant associations.

Conclusion: Mortality was heightened among SRI patients who were older, required critical care, had chronic conditions and infected with SARS-CoV-2 suggesting need for early identification of these conditions to improve possible treatment outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信