尼日利亚一家三级医院新冠肺炎患者的人口学特征、临床表现和住院结果

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Juliet I Mmerem, Uche S Unigwe, Michael O Iroezindu, Kyrian S Chukwu, Ifeyinwa L Ezenwosu, Geofrey O Okorie, Nneka M Chika-Igwenyi, Chidinma B Nwatu, Obinna D Onodugo
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引用次数: 0

摘要

背景我们描述了尼日利亚大学教学医院(UNTH)新冠肺炎患者在第一波疫情期间的人口统计学/临床特征和住院结果,为非洲随后几波疫情期间的循证应对提供信息。方法我们对PCR或GeneXpert确诊的严重急性呼吸系统综合征冠状病毒2型感染的≥18岁成年患者进行了回顾性队列分析。数据取自2020年5月1日至9月30日患者的医疗记录。根据疾病的严重程度,患者要么住院治疗(82),要么在家治疗(90)。采用逻辑回归和多因素危险模型分别确定严重新冠肺炎疾病和住院死亡率的预测因素。结果172例患者中,男性113例(65.7%),平均年龄45±19岁。大多数是城市居民(72.1%),19.8%有确诊/疑似病例的阳性接触史,15.7%是医护人员,68人(39.5%)有合并症。有症状的患者占病例的73.3%。发烧(p=0.02)和呼吸困难(p=0.03)在男性中更常见,而腹泻(p<0.01)在女性中占主导地位。在多变量分析中,严重的新冠肺炎是通过合并发病(AOR=14.44,95%C.I=4.79-43.58,p<0.001)和既往使用抗生素/抗疟药物(AOR=6.35,95%C.I=2.24-18.05,p=0.001)来预测的,而非医护人员(AOR=0.18,95%C.I.=0.04-0.78,p=0.02)具有保护性。然而,评估的任何变量都无法预测住院死亡率。结论我们的研究结果强调了人口统计学变量在新冠肺炎传播中的作用以及临床表现中的性别差异。潜在的合并症同样是先前使用抗菌药物增加了严重新冠肺炎的可能性。我们的研究中缺乏死亡率预测因素可能与死亡人数相对较少有关。建议进行进一步的研究,以揭示重症在医护人员中的主导地位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital.

Background: We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa.

Methodology: We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively.

Results: Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality.

Conclusion: Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.

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来源期刊
Malawi Medical Journal
Malawi Medical Journal Medicine-General Medicine
CiteScore
1.50
自引率
0.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region. Topics covered in the journal include, but are not limited to: - Communicable diseases (HIV and AIDS, Malaria, TB, etc.) - Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.) - Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.) - Mental health - Environmental health - Nutrition - Health systems and health policy (Leadership, ethics, and governance) - Community systems strengthening research - Injury, trauma, and surgical disorders
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