Risk factors for severity on admission and the disease progression during hospitalisation in a large cohort of patients with COVID-19 in Japan.
Risk factors for severity on admission and the disease progression during hospitalisation in a large cohort of patients with COVID-19 in Japan.
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DOI：
10.1136/bmjopen-2020-047007
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发表时间：
2021-06-15
期刊：
影响因子：
2.9
通讯作者：
Ohmagari N
中科院分区：
文献类型：
--
作者：
Terada M;Ohtsu H;Saito S;Hayakawa K;Tsuzuki S;Asai Y;Matsunaga N;Kutsuna S;Sugiura W;Ohmagari N
目的：探讨入院时影响严重程度的危险因素。此外，还研究了最严重程度和病死率的危险因素。并根据早期严重程度、最严重程度和病死率3个点对各因素进行比较。一项观察性队列研究，使用日本全国COVID-19住院患者登记处COVIREGI-JP输入的数据。截至2020年9月28日，已登记802个设施的10480例病例。参与机构涵盖了日本境内收治新冠肺炎患者的众多医院。在任何适用的SARS-CoV-2诊断测试中检测结果呈阳性的参与者被允许进入参与的医疗机构。2020年1月16日至5月31日共发现3829例病例，其中3376例纳入本研究。入院时的主要结局是严重或非严重，由机械通气或氧疗的需求、SpO2或呼吸速率决定。次要结局是住院期间最严重的严重程度，通过氧气需求和/或有创机械通气/体外膜氧合来判断。入院时严重程度的危险因素为年龄较大、男性、心血管疾病、慢性呼吸系统疾病、糖尿病、肥胖和高血压。脑血管疾病、肝脏疾病、肾脏疾病或透析、实体瘤和高脂血症对入院时的严重程度没有影响；然而，它影响了最严重的程度。肥胖、高血压和高脂血症的死亡率相对较低。本研究分离了影响严重程度和死亡的合并症。入院时严重程度、最严重程度和死亡的危险因素可能不一致，可能由不同因素推动。具体来说，虽然高血压、高脂血症和肥胖对最严重程度有重大影响，但它们对日本人口死亡率的影响较小。一些研究与我们的结果相矛盾；因此，需要详细的分析，考虑到住院治疗，以验证。UMIN000039873。https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045453
To investigate the risk factors contributing to severity on admission. Additionally, risk factors of worst severity and fatality were studied. Moreover, factors were compared based on three points: early severity, worst severity and fatality. An observational cohort study using data entered in a Japan nationwide COVID-19 inpatient registry, COVIREGI-JP. As of 28 September 2020, 10480 cases from 802 facilities have been registered. Participating facilities cover a wide range of hospitals where patients with COVID-19 are admitted in Japan. Participants who had a positive test result on any applicable SARS-CoV-2 diagnostic tests were admitted to participating healthcare facilities. A total of 3829 cases were identified from 16 January to 31 May 2020, of which 3376 cases were included in this study. Primary outcome was severe or nonsevere on admission, determined by the requirement of mechanical ventilation or oxygen therapy, SpO2 or respiratory rate. Secondary outcome was the worst severity during hospitalisation, judged by the requirement of oxygen and/orinvasive mechanical ventilation/extracorporeal membrane oxygenation. Risk factors for severity on admission were older age, men, cardiovascular disease, chronic respiratory disease, diabetes, obesity and hypertension. Cerebrovascular disease, liver disease, renal disease or dialysis, solid tumour and hyperlipidaemia did not influence severity on admission; however, it influenced worst severity. Fatality rates for obesity, hypertension and hyperlipidaemia were relatively lower. This study segregated the comorbidities influencing severity and death. It is possible that risk factors for severity on admission, worst severity and fatality are not consistent and may be propelled by different factors. Specifically, while hypertension, hyperlipidaemia and obesity had major effect on worst severity, their impact was mild on fatality in the Japanese population. Some studies contradict our results; therefore, detailed analyses, considering in-hospital treatments, are needed for validation. UMIN000039873. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045453
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DOI：
10.1161/atvbaha.112.248559
发表时间：
2012-06
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Gupte M;Thatcher SE;Boustany-Kari CM;Shoemaker R;Yiannikouris F;Zhang X;Karounos M;Cassis LA
通讯作者：
Cassis LA
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
12.7
作者：
Duan, Jun;Wang, Xiaohui;Guo, Shuliang
通讯作者：
Guo, Shuliang
影响因子：
64.8
作者：
Crackower, MA;Sarao, R;Penninger, JM
通讯作者：
Penninger, JM
影响因子：
14.2
作者：
Jackson, Daniel J.;Busse, William W.;Altman, Mathew C.
通讯作者：
Altman, Mathew C.