Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection
Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection
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DOI：
10.1093/cid/ciaa1535
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发表时间：
2021-07-01
影响因子：
11.8
通讯作者：
Glybochko, Petr
中科院分区：
文献类型：
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作者：
Munblit, Daniel;Nekliudov, Nikita A.;Glybochko, Petr
背景资料。俄罗斯人群中2019年冠状病毒病(新冠肺炎)患者的流行病学、临床病程和结果尚不清楚。实验室确认的新冠肺炎与临床诊断的新冠肺炎在现实生活中的差异的信息很少。我们从2020年4月8日至5月28日在莫斯科因疑似新冠肺炎感染而连续入院的成年患者的医疗记录中提取数据。在4,261名因疑似新冠肺炎而住院的患者中，有3,480名患者(中位年龄，56岁；四分位数范围，45-66岁)可获得结果。最常见的并发症是高血压、肥胖症、慢性心血管疾病和糖尿病。半数患者逆转录聚合酶链式反应阳性，1748例逆转录聚合酶链式反应阴性，但有临床症状和特征性CT征象提示新冠肺炎。在完全临床诊断的SARS冠状病毒2型(SARS-CoV-2)RT-PCR阳性患者之间，在症状出现频率、实验室检测结果和住院死亡危险因素方面没有显著差异。在多因素Logistic回归模型中，以下因素与住院死亡率有关：高龄(每增加1年；优势比1.05；95%可信区间1.03-1.06)，男性(1.71；1.24-2.37)，慢性肾病(2.99；1.89-4.64)，糖尿病(2.1；1.46-2.99)，慢性心血管疾病(1.78；1.24-2.57)，痴呆症(2.73；1.34-5.47)。年龄、男性和慢性合并症是住院死亡率的危险因素。结合临床特征足以诊断新冠肺炎感染，这表明实验室检测在现实生活的临床实践中并不关键。
Background. The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking.Methods. We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020.Results. Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47).Conclusions. Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.