Clinical Outcomes of Patients Hospitalized with Coronavirus Disease 2019 (COVID-19) in Boston.
Clinical Outcomes of Patients Hospitalized with Coronavirus Disease 2019 (COVID-19) in Boston.
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DOI：
10.1007/s11606-021-06622-x
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发表时间：
2021-05
影响因子：
5.7
通讯作者：
Volandes A
中科院分区：
文献类型：
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作者：
El-Jawahri A;Bohossian HB;Paasche-Orlow MK;Lakin JR;Johnson PC;Cooper Z;Jagielo AD;Brannen EN;Reynolds MJ;Coogan K;Vaughn D;Volandes A
在病例激增、不堪重负的卫生系统中，已经描述了COVID-19住院患者的结局。然而，缺乏对非危机医院收治的患者结果的研究。描述所有非危机医院收治的COVID-19患者的临床特征和结局，以及与该人群死亡率相关的因素。回顾性分析从2020年1月1日至2020年4月15日，共有470名连续COVID-19患者需要在波士顿的一个卫生系统住院治疗。我们收集住院期间的临床结果，包括重症监护室（ICU）入院，接受机械通气和血管加压药。我们利用多变量逻辑回归模型来研究与死亡率相关的因素。共纳入470例患者（中位年龄66岁[范围23-98岁]，54.0%为男性）。最常见的合并症是糖尿病（38.5%，181/470）和肥胖（41.3%，194/470）。入院时，41.9%（197/470）的患者发热，60.6%（285/470）的患者需要辅助供氧。住院期间，37.9%（178/470）的患者入住ICU，33.6%（158/470）的患者接受机械通气，29.4%（138/470）的患者接受血管加压药，16.4%（77/470）的患者报告其对维持生命治疗（如插管和心肺复苏）的需求有限，死亡118例（25.1%）。在入住ICU的患者（N=178）中，使用呼吸机的中位天数为10天（IQR 1-29），58.4%（104/178）的患者存活出院。年龄较大（OR=1.04，P<0.001），男性（OR=2.14，P=0.007），合并症较高（OR=1.20，P=0.001），入院时乳酸脱氢酶升高（第2三分位数：OR=4.07，P<0.001;第3三分位数：OR=8.04，P<0.001）和入院时需要补充氧气（OR=2.17，P=0.014）均与较高的死亡率相关。大部分COVID-19住院患者和接受机械通气的患者均存活。这些数据突出表明，有必要审查有助于改善这一人群结果的公共卫生和系统因素。在线版本包含补充材料，可通过10.1007/s11606-021-06622-x获得。
Outcomes of hospitalized patients with COVID-19 have been described in health systems overwhelmed with a surge of cases. However, studies examining outcomes of patients admitted to hospitals not in crisis are lacking. To describe clinical characteristic and outcomes of all patients with COVID-19 who are admitted to hospitals not in crisis, and factors associated with mortality in this population. A retrospective analysis In total, 470 consecutive patients with COVID-19 requiring hospitalization in one health system in Boston from January 1, 2020 to April 15, 2020. We collected clinical outcomes during hospitalization including intensive care unit (ICU) admission, receipt of mechanical ventilation, and vasopressors. We utilized multivariable logistic regression models to examine factors associated with mortality. A total of 470 patients (median age 66 [range 23–98], 54.0% male) were included. The most common comorbidities were diabetes (38.5%, 181/470) and obesity (41.3%, 194/470). On admission, 41.9% (197/470) of patients were febrile and 60.6% (285/470) required supplemental oxygen. During hospitalization, 37.9% (178/470) were admitted to the ICU, 33.6% (158/470) received mechanical ventilation, 29.4% (138/470) received vasopressors, 16.4% (77/470) reported limitations on their desire for life-sustaining therapies such as intubation and cardiopulmonary resuscitation, and 25.1% (118/470) died. Among those admitted to the ICU (N=178), the median number of days on the ventilator was 10 days (IQR 1–29), and 58.4% (104/178) were discharged alive. Older age (OR=1.04, P<0.001), male sex (OR=2.14, P=0.007), higher comorbidities (OR=1.20, P=0.001), higher lactate dehydrogenase on admission (2nd tertile: OR=4.07, P<0.001; 3rd tertile: OR=8.04, P<0.001), and the need for supplemental oxygen on admission (OR=2.17, P=0.014) were all associated with higher mortality. The majority of hospitalized patients with COVID-19 and those who received mechanical ventilation survived. These data highlight the need to examine public health and system factors that contribute to improved outcomes for this population. The online version contains supplementary material available at 10.1007/s11606-021-06622-x.
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影响因子：
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作者：
Bursac, Zoran;Gauss, C Heath;Williams, David Keith;Hosmer, David W
通讯作者：
Hosmer, David W
DOI：
10.1073/pnas.2004064117
发表时间：
2020-04-21
影响因子：
11.1
作者：
Moghadas, Seyed M.;Shoukat, Affan;Galvani, Alison P.
通讯作者：
Galvani, Alison P.
影响因子：
4.1
作者：
Oh, Juhwan;Lee, Jong-Koo;Hirschhorn, Lisa R.
通讯作者：
Hirschhorn, Lisa R.
影响因子：
2.8
作者：
Dumanovsky, Tamara;Rogers, Maggie;Meier, Diane E.
通讯作者：
Meier, Diane E.
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
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作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
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