Early Outcomes of SARS-CoV-2 Infection in a Multisite Prospective Cohort of Inpatient Veterans.
Early Outcomes of SARS-CoV-2 Infection in a Multisite Prospective Cohort of Inpatient Veterans.
复制标题
住院退伍军人多地点前瞻性队列中 SARS-CoV-2 感染的早期结果。
DOI：
10.1093/ofid/ofad330
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发表时间：
2023
影响因子：
4.2
通讯作者：
Holo
中科院分区：
文献类型：
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作者：
Ross,JenniferM;Sugimoto,JonathanD;Timmons,Andrew;Adams,Jonathan;Deardoff,Katrina;Korpak,Anna;Liu,Cindy;Moore,Kathryn;Wilson,Deanna;Bedimo,Roger;Chang,Kyong-Mi;Cho,Kelly;Crothers,Kristina;Garshick,Eric;Gaziano,JMichael;Holo
背景退伍军人健康管理局使用者中发生了超过87万例严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染，其中24000例导致死亡。我们研究了SARS-CoV-2感染住院veterines.MethodsIn一项正在进行的前瞻性队列研究的早期结果，我们招募了年龄≥18岁的退伍军人进行SARS-CoV-2检测，并在2021年2月至2022年6月期间在15个退伍军人事务部医疗中心住院。我们估计了研究开始后30天内最大疾病严重程度的校正比值比（aOR）、校正发病率比（aIRR）和校正风险比（aHR（使用2019年冠状病毒病[COVID-19]的4类VA严重程度指数定义），以及60天内住院和再住院的时间，与人口统计学特征的关系，Charlson合并症指数（CCI）、COVID-19疫苗接种和入组日历期。结果542名参与者中有329人（61%）完成了初级疫苗系列（有或没有加强;“接种”），292（54%）登记为SARS-CoV-2阳性，503（93%）男性，平均年龄为64.4岁。高CCI评分（≥5）发生在61（44%）接种疫苗和29（19%）未接种疫苗的SARS-CoV-2阳性参与者中。严重疾病或死亡发生在29（21%; 6%死亡）接种疫苗和31（20%; 2%死亡）未接种SARS-CoV-2阳性参与者。CCI每增加一个单位，SARS-CoV-2阳性住院患者发生严重疾病的多变量调整几率更大（aOR，1.21; 95% CI，1.01-1.45），住院天数更多（aIRR，1.06; 95% CI，1.03-1.10）和再住院（aHR，1.07; 95%CI，1.01-1.12）。结论在一组患有SARS-CoV-2感染的住院美国退伍军人中，CCI较高的人有更严重的COVID-19疾病，更多的住院天数和再住院，在调整疫苗接种状态、年龄、性别和日历周期后。
BackgroundOver 870 000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections have occurred among Veterans Health Administration users, and 24 000 have resulted in death. We examined early outcomes of SARS-CoV-2 infection in hospitalized veterans.MethodsIn an ongoing, prospective cohort study, we enrolled veterans age ≥18 tested for SARS-CoV-2 and hospitalized at 15 Department of Veterans Affairs medical centers between February 2021 and June 2022. We estimated adjusted odds ratios (aORs), adjusted incidence rate ratios (aIRRs), and adjusted hazard ratios (aHRs) for maximum illness severity within 30 days of study entry (defined using the 4-category VA Severity Index for coronavirus disease 2019 [COVID-19]), as well as length of hospitalization and rehospitalization within 60 days, in relationship with demographic characteristics, Charlson comorbidity index (CCI), COVID-19 vaccination, and calendar period of enrollment.ResultsThe 542 participants included 329 (61%) who completed a primary vaccine series (with or without booster; “vaccinated”), 292 (54%) enrolled as SARS-CoV-2-positive, and 503 (93%) men, with a mean age of 64.4 years. High CCI scores (≥5) occurred in 61 (44%) vaccinated and 29 (19%) unvaccinated SARS-CoV-2-positive participants. Severe illness or death occurred in 29 (21%; 6% died) vaccinated and 31 (20%; 2% died) unvaccinated SARS-CoV-2-positive participants. SARS-CoV-2-positive inpatients per unit increase in CCI had greater multivariable-adjusted odds of severe illness (aOR, 1.21; 95% CI, 1.01–1.45), more hospitalization days (aIRR, 1.06; 95% CI, 1.03–1.10), and rehospitalization (aHR, 1.07; 95% CI, 1.01–1.12).ConclusionsIn a cohort of hospitalized US veterans with SARS-CoV-2 infection, those with a higher CCI had more severe COVID-19 illness, more hospital days, and rehospitalization, after adjusting for vaccination status, age, sex, and calendar period.