SARS-CoV-2 infection in the COPD population is associated with increased healthcare utilization: An analysis of Cleveland clinic's COVID-19 registry
SARS-CoV-2 infection in the COPD population is associated with increased healthcare utilization: An analysis of Cleveland clinic's COVID-19 registry
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DOI：
10.1016/j.eclinm.2020.100515
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发表时间：
2020-09-01
影响因子：
15.1
通讯作者：
Hatipoglu, Umur S.
中科院分区：
文献类型：
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作者：
Attaway, Amy A.;Zein, Joe;Hatipoglu, Umur S.
背景：我们试图确定 COPD 是否会因 COVID-19 而导致住院和临床结果方面的医疗保健利用风险更高。方法：在俄亥俄州和佛罗里达州的克利夫兰诊所卫生系统进行了一项使用多变量逻辑回归进行协变量调整的队列研究。纳入了在 2020 年 3 月 8 日至 5 月 13 日期间接受 SARS-CoV-2 检测的年龄 35 岁及以上、有症状的患者。结果：2020 年 3 月 8 日至 2020 年 5 月 13 日期间，克利夫兰诊所有 15,586 名接受了 COVID-19 检测的个体符合我们的纳入标准。 12.4% 的慢性阻塞性肺病患者 (164/1319) 检测出 COVID-19 呈阳性，而非慢性阻塞性肺病患者的这一比例为 16.6% (2363/14,267)。 48.2% (79/164) 的 COVID-19 阳性 COPD 患者需要住院治疗，45.6% (36/79) 需要入住 ICU。调整协变量后，COVID-19 感染率与非 COPD 人群没有显着差异（调整 OR 0.97；CI：0.89 -1.05），但 COPD 患者的医疗保健利用率有所增加，如住院风险（调整 OR 1.36；CI：1.15-1.60）、入住 ICU（OR 1.20；CI：1.02-1.40）和需要有创机械通气（调整 OR 1.49；CI：1.28-1.73）。 COPD 人群中未经调整的院内死亡率风险较高（OR 1.51；CI：1.14-1.96）。然而，调整协变量后，院内死亡风险与非 COPD 人群没有显着差异（调整 OR 1.08：CI：0.81-1.42）。 解释：我们的分析表明，尽管调整后的院内死亡风险与非 COPD 感染 COVID-19 的患者没有差异，但合并 COVID-19 的 COPD 患者的医疗利用风险较高。 (C) 2020 作者。由爱思唯尔有限公司出版
Background: We sought to determine whether COPD conferred a higher risk for healthcare utilization in terms of hospitalization and clinical outcomes due to COVID-19.Methods: A cohort study with covariate adjustment using multivariate logistic regression was conducted at the Cleveland Clinic Health System in Ohio and Florida. Symptomatic patients aged 35 years and older who were tested for SARS-CoV-2 between March 8 and May 13, 2020 were included.Findings: 15,586 individuals tested for COVID-19 at the Cleveland Clinic between March 8, 2020 and May 13, 2020 met our inclusion criteria. 12.4% of COPD patients (164/1319) tested positive for COVID-19 compared to 16.6% (2363/14,267) of the non-COPD population. 48.2% (79/164) of COVID-19 positive COPD patients required hospitalization and 45.6% (36/79) required ICU admission. After adjustment for covariates, rates of COVID-19 infection were not significantly different than the non-COPD population (adj OR 0.97; CI: 0.89 -1.05), but COPD patients had increased healthcare utilization as demonstrated by risk for hospitalization (adj OR 1.36; CI: 1.15-1.60), ICU admission (OR 1.20; CI: 1.02-1.40), and need for invasive mechanical ventilation (adj OR 1.49; CI: 1.28-1.73). Unadjusted risk for in-hospital mortality was higher in the COPD population (OR 1.51; CI: 1.14-1.96). After adjusting for covariates however, the risk for in-hospital mortality was not significantly different than the non-COPD population (adj OR 1.08: CI: 0.81-1.42).Interpretation: Our analysis demonstrated that COPD patients with COVID-19 had a higher risk for healthcare utilization, although adjusted in-hospital mortality risk was not different than the non-COPD patients with COVID-19. (C) 2020 The Authors. Published by Elsevier Ltd.