Pregnancy and the Risk of In-Hospital Coronavirus Disease 2019 (COVID-19) Mortality.
Pregnancy and the Risk of In-Hospital Coronavirus Disease 2019 (COVID-19) Mortality.
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DOI：
10.1097/aog.0000000000004744
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发表时间：
2022-05-01
影响因子：
7.2
通讯作者：
Harris, Anthony D.
中科院分区：
文献类型：
--
作者：
Pineles, Beth L.;Goodman, Katherine E.;Pineles, Lisa;O'Hara, Lyndsay M.;Nadimpalli, Gita;Magder, Laurence S.;Baghdadi, Jonathan D.;Parchem, Jacqueline G.;Harris, Anthony D.
在因2019冠状病毒病（COVID-19）导致的肺炎住院的育龄患者的大型队列中，妊娠不是住院死亡的独立风险因素。评估妊娠是否是因2019冠状病毒病（COVID-19）病毒性肺炎住院的育龄患者住院死亡的独立风险因素。我们进行了一项回顾性队列研究（2020年4月至2021年5月），研究对象为23，574名年龄在15-45岁之间的女性住院患者，这些患者在Premier Healthcare数据库中的749家美国医院出院，符合国际疾病分类第十版临床修改诊断代码。我们使用病毒性肺炎诊断来选择有症状的COVID-19患者。采用倾向评分匹配的条件Logistic回归分析妊娠与住院死亡率、重症监护室（ICU）入院和机械通气之间的关系。模型在年龄、婚姻状况、种族和民族、Elixhauser合并症评分、付款人、医院床位数、出院季节、医院区域、肥胖、高血压、糖尿病、慢性肺病、缺乏性贫血、抑郁症、甲状腺功能减退症和肝病方面进行匹配。因COVID-19和病毒性肺炎住院的妊娠患者和非妊娠患者的院内死亡率分别为1.1%和3.5%（倾向评分匹配比值比[OR] 0.39，95%CI 0.25-0.63）。妊娠和非妊娠患者入住ICU的频率分别为22.0%和17.7%（OR 1.34，95%CI 1.15-1.55）。在8.7%的妊娠和非妊娠患者中使用机械通气（OR 1.05，95%CI 0.86-1.29）。在入住ICU的患者中，妊娠患者的死亡率低于非妊娠患者（OR 0.33，95% CI 0.20-0.57），但机械通气率相似（35.7% vs 38.3%，OR 0.90，95% CI 0.70-1.16）。在机械通气患者中，妊娠患者的院内死亡风险低于非妊娠患者（0.26，95% CI 0.15-0.46）。尽管入住ICU的频率较高，但与非妊娠的COVID-19病毒性肺炎患者相比，妊娠患者的住院死亡率较低，并且在倾向评分匹配后，这些发现仍然存在。
In a large cohort of reproductive-aged patients hospitalized with pneumonia due to coronavirus disease 2019 (COVID-19), pregnancy was not an independent risk factor for in-hospital mortality. To evaluate whether pregnancy is an independent risk factor for in-hospital mortality among patients of reproductive age hospitalized with coronavirus disease 2019 (COVID-19) viral pneumonia. We conducted a retrospective cohort study (April 2020–May 2021) of 23,574 female inpatients aged 15–45 years with an International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code for COVID-19 discharged from 749 U.S. hospitals in the Premier Healthcare Database. We used a viral pneumonia diagnosis to select for patients with symptomatic COVID-19. The associations between pregnancy and in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation were analyzed using propensity score–matched conditional logistic regression. Models were matched for age, marital status, race and ethnicity, Elixhauser comorbidity score, payer, hospital number of beds, season of discharge, hospital region, obesity, hypertension, diabetes mellitus, chronic pulmonary disease, deficiency anemias, depression, hypothyroidism, and liver disease. In-hospital mortality occurred in 1.1% of pregnant patients and 3.5% of nonpregnant patients hospitalized with COVID-19 and viral pneumonia (propensity score–matched odds ratio [OR] 0.39, 95% CI 0.25–0.63). The frequency of ICU admission for pregnant and nonpregnant patients was 22.0% and 17.7%, respectively (OR 1.34, 95% CI 1.15–1.55). Mechanical ventilation was used in 8.7% of both pregnant and nonpregnant patients (OR 1.05, 95% CI 0.86–1.29). Among patients who were admitted to an ICU, mortality was lower for pregnant compared with nonpregnant patients (OR 0.33, 95% CI 0.20–0.57), though mechanical ventilation rates were similar (35.7% vs 38.3%, OR 0.90, 95% CI 0.70–1.16). Among patients with mechanical ventilation, pregnant patients had a reduced risk of in-hospital mortality compared with nonpregnant patients (0.26, 95% CI 0.15–0.46). Despite a higher frequency of ICU admission, in-hospital mortality was lower among pregnant patients compared with nonpregnant patients with COVID-19 viral pneumonia, and these findings persisted after propensity score matching.
免疫、凝血和纤溶过程可能会降低患有 2019 年冠状病毒病的孕妇患严重疾病的风险
影响因子：
9.8
作者：
Zhong Y;Cao Y;Zhong X;Peng Z;Jiang S;Tang T;Chen H;Li X;Xia Y;Cheng Y;Zhao X
通讯作者：
Zhao X