Outcomes of COVID-19 and Factors Associated With Its Severity Among Hospitalized Patients With and Without Systemic Rheumatic Disease During the First Wave of the Pandemic in New York City.
Outcomes of COVID-19 and Factors Associated With Its Severity Among Hospitalized Patients With and Without Systemic Rheumatic Disease During the First Wave of the Pandemic in New York City.
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纽约市第一波大流行期间患有和不患有系统性风湿病的住院患者中 COVID-19 的结果及其严重程度相关的因素。
DOI：
10.1097/rhu.0000000000001891
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Barbhaiya,Medha
中科院分区：
文献类型：
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作者：
Siegel,CarolineH;Choi,JackyM;D'Angelo,Debra;Christos,Paul;Lally,Lindsay;Navarro-Millan,Iris;Cooke,Joseph;Goyal,Parag;Mandl,LisaA;Barbhaiya,Medha
方法我们开展了一项病历审查研究，纳入了 2020 年 3 月 3 日至 5 月 15 日在纽约长老会医院 3 个地点住院的年龄≥ 18 岁确诊 SARS-CoV-2 感染的患者。将治疗加权的逆概率应用于多变量逻辑回归模型，以评估 SRD 状态与机械通气、重症监护病房入院或死亡的综合数据之间的关联。结果 3710 名因 COVID-19 住院的患者（平均值 [SD]）年龄，63.7 [17.0] 岁；41% 为女性，29% 为白人，34% 为西班牙裔/拉丁裔），92 名（2.5%）患有 SRD。与没有 SRD 的患者相比，SRD 患者的年龄和体重指数相似，但更有可能是女性、曾经吸烟者、白人或黑人。与未患有 SRD 的患者相比，患有高血压和肺部疾病的患者比例更高，并且在入院前使用羟氯喹、皮质类固醇和免疫调节/免疫抑制药物。在加权多变量分析中，与没有 SRD 的患者相比，SRD 患者的机械通气、重症监护病房入院或死亡的综合优势比为 1.24（95% 置信区间为 1.10-1.41；p< 0.01）。 结论 在纽约市疫情的最初高峰期，因 COVID-19 住院的 SRD 患者与未患 SRD 的患者相比，在住院后患重症 COVID-19 的可能性增加了 24%。多变量调整。
MethodsWe conducted a medical records review study including patients aged≥ 18 years with confirmed SARS-CoV-2 infection hospitalized at 3 NewYork-Presbyterian sites, March 3–May 15, 2020. Inverse probability of treatment weighting was applied to a multivariable logistic regression model to assess the association between SRD status and the composite of mechanical ventilation, intensive care unit admission, or death.ResultsOf 3710 patients hospitalized with COVID-19 (mean [SD] age, 63.7 [17.0] years; 41% female, 29% White, and 34% Hispanic/Latinx), 92 (2.5%) had SRD. Patients with SRD had similar age and body mass index but were more likely to be female, ever smokers, and White or Black, compared with those without SRD. A higher proportion of patients with versus without SRD had hypertension and pulmonary disease, and used hydroxychloroquine, corticosteroids, and immunomodulatory/immunosuppressive medications before admission. In the weighted multivariable analysis, patients with SRD had an odds ratio of 1.24 (95% confidence interval, 1.10–1.41; p< 0.01) for the composite of mechanical ventilation, intensive care unit admission, or death, compared with patients without SRD.ConclusionsDuring the initial peak of the pandemic in New York City, patients with versus without SRD hospitalized with COVID-19 had a 24% increased likelihood of having severe COVID-19 after multivariable adjustment.