埃斯特雷马杜拉两个卫生区在大流行前六个月SARS-CoV-2感染临床演变的预测变量

IF 0.9 Q4 PRIMARY HEALTH CARE

Medicina de Familia-SEMERGEN Pub Date : 2025-06-11 DOI:10.1016/j.semerg.2025.102531

Manuel Tejero-Mas , Alba Palmerín-Donoso , José Antonio Morales-Gabardino , María José Gamero-Samino , Leandro Fernández-Fernández , Francisco Buitrago-Ramírez

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引用次数: 0

摘要

目的探讨2019冠状病毒病疫情前半期（2020年3月1日至2020年8月31日）埃斯特雷马杜拉两个卫生区COVID-19患者不良临床进展（住院和/或死亡）的预测变量。患者和方法：观察性、分析性和双面性研究，随访2年。排除临床文件不完整或诊断不明确的患者。共排除216例患者，最终样本为1422例患者。包括临床和社会人口学特征、合并症和感染过程。进行多变量分析以确定医院急诊科（HED）就诊、住院和死亡率的预测因子。结果平均年龄45.6岁；53.2%的女性。14.2%的患者临床进展不良，2.0%的患者死亡。年龄是HED就诊、住院和死亡的预测因子。普通人群和住院患者死亡率的最高比值比（OR）与自身免疫性疾病或器官移植的存在相关：OR: 9.02；95%置信区间（95% CI）： 1.72 ~ 47.21, OR: 8.06；95% CI分别为1.17-55.53。HED就诊的预测因子包括自身免疫性疾病或移植、慢性阻塞性肺疾病和心血管疾病。家庭医生的转诊报告（FP）是预测普通人群住院或不良结局能力最大的变量(or: 44.15；95% CI: 27.14-71.83, OR: 43.29；95% CI分别为26.28-71.29)。结论FP向HED的转诊报告是住院和不良结局的最强预测因子。

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Variables predictoras de evolución clínica de la infección por SARS-CoV-2 durante el primer semestre de pandemia en 2 áreas de salud de Extremadura

Objective

To identify predictive variables of unfavorable clinical evolution (hospital admission and/or death) in patients with COVID-19 during the first half of the pandemic (01-03-2020 to 31-08-2020) in two health areas of Extremadura.

Patients and methods

Observational, analytical and ambispective study with a two-year follow-up. Patients with incomplete clinical documentation or without confirmed diagnosis where excluded. A total of 216 patients were excluded, resulting in a final sample of 1422 patients. Clinical and sociodemographic characteristics, comorbidities, and the course of the infection were included. A multivariate analysis was performed to identify predictors of hospital emergency department (HED) visits, hospital admissions, and mortality.

Results

Mean age 45.6 years; 53.2% women. 14.2% of patients had an unfavorable clinical evolution and 2.0% died. Age was a predictor of HED visits, hospital admission and death. The highest odds ratio (OR) for mortality in both general population and hospitalized patients was associated with the presence of autoimmune diseases or organ transplants: OR: 9.02; 95% confidence interval (95% CI): 1.72-47.21 and OR: 8.06; 95% CI: 1.17-55.53, respectively. Predictors of HED visits included autoimmune disease or transplant, chronic obstructive pulmonary disease, and cardiovascular diseases. The referral report made by the family physician (FP) was the variable with the greatest predictive capacity for hospital admission or unfavorable outcome in the general population (OR: 44.15; 95% CI: 27.14-71.83 and OR: 43.29; 95% CI: 26.28-71.29, respectively).