Risk factors for COVID-19 mortality in hospitalized patients in Bolivia.
Risk factors for COVID-19 mortality in hospitalized patients in Bolivia.
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DOI：
10.1016/j.ijregi.2023.10.002
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发表时间：
2023-12
期刊：
影响因子：
--
通讯作者：
Eid, Daniel
中科院分区：
文献类型：
--
作者：
Limachi-Choque, Jhonny;Guitian, Javier;Leyns, Christine;Guzman-Rivero, Miguel;Eid, Daniel
尽管人口年轻，但玻利维亚是COVID-19超额死亡率最高的国家之一。在住院患者中，年龄较大和死亡率从相对年轻的年龄开始相关。A血型在高原土著人中很少见，与较高的死亡率相关这项研究旨在确定哪些因素与住院的COVID-19玻利维亚患者的较高死亡风险相关。这项回顾性观察性研究评估了与2020年4月6日至2022年8月18日期间在玻利维亚医院因SARS-CoV-2感染住院的患者（n = 549）死亡率相关的风险因素。这些结果提供了证据表明，（比值比[OR] = 1.6，95%置信区间[CI] 1.06-2.6），年龄较大，51-61岁（OR = 5.2，95%CI 2.2-12.6），62-70岁（OR = 8.7，95%CI：3.7-20.5），>70岁（OR = 16.9，95%CI：7.1-39.9），A型血（OR = 1.9，95%CI：1.1-3.4）死亡风险较高。死亡率和相对年轻的年龄之间的强相关性可能是由于未诊断的合并症的高频率。仅当住院时间未调整时，疫苗接种与死亡率降低相关。在玻利维亚的住院患者中，男性、年龄较大和A型血与较高的死亡风险相关。死亡风险从相对年轻的年龄开始显著增加，并随着接种计划的实施而降低。然而，死亡率的逐渐降低也可能是由于随着大流行的进展，患者管理得到改善，自然免疫力和流行菌株的毒力发生了变化。
Bolivia had one of the highest COVID-19 excess mortality despite its young population. In the hospitalized, older age and mortality are associated from relatively young age. Blood group A, rare in highland indigenous people, is associated with higher mortality This study aimed to ascertain which factors are associated with higher risk of mortality among hospitalized COVID-19 Bolivian patients. This retrospective observational study assessed risk factors associated with mortality in patients (n = 549) hospitalized for SARS-CoV-2 infection in a Bolivian hospital between April 6, 2020, and August 18, 2022. The results provide evidence of association between male sex (odds ratio [OR] = 1.6, 95% confidence interval [CI] 1.06-2.6), older age, 51-61 years-old (OR = 5.2, 95% CI 2.2-12.6), 62-70 years-old (OR = 8.7, 95% CI 3.7-20.5), >70 years-old (OR = 16.9, 95% CI 7.1-39.9), and blood group A (OR = 1.9, 95% CI: 1.1-3.4) with higher mortality risk. The strong association between mortality and relatively young age, may be due to high frequency of undiagnosed comorbidities. Vaccination was associated with a reduction in mortality only when time period of hospitalization was not adjusted for. Among hospitalized patients in Bolivia male sex, older age, and blood group A are associated with higher mortality risk. Mortality risk increased markedly from a relatively young age and decreased in parallel to the uptake of the vaccination program. However, the gradual reduction in mortality can also be due to improved patient management and changes in natural immunity and virulence of circulating strains as the pandemic progressed.
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