Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: A federated electronic medical record analysis
Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: A federated electronic medical record analysis
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DOI：
10.1371/journal.pmed.1003321
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发表时间：
2020-09-01
期刊：
影响因子：
15.8
通讯作者：
Lip, Gregory Y. H.
中科院分区：
文献类型：
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作者：
Harrison, Stephanie L.;Fazio-Eynullayeva, Elnara;Lip, Gregory Y. H.
作者摘要：为什么要做这项研究？冠状病毒病2019(新冠肺炎)引发国际突发公共卫生事件。截至2020年6月，全球新冠肺炎报告的死亡人数超过40万人，美国超过11万人，但许多人也已经康复。由于新冠肺炎在全球范围内史无前例的爆发，人们对哪些潜在的健康状况可能会影响一个人死于新冠肺炎的可能性知之甚少。以前的一些研究表明，年龄较大、黑人、亚洲人或少数族裔背景，以及有特定的健康状况可能会增加患新冠肺炎的死亡风险，但需要进一步的证据来了解影响这些因素的因素。研究人员做了什么并发现了什么？这项研究利用了美国24个医疗保健组织的网络，这些组织从患者的电子医疗记录中提供身份识别的数据。在2020年1月20日至2020年5月26日期间对该网络进行搜索后，共有31461名电子病历中包含新冠肺炎代码的成年人参与了这项研究。在研究期间，我们确定了年龄、性别、种族、合并症和死亡与新冠肺炎之间的关联。在考虑了研究中的其他纳入因素后，年龄较大、男性、黑人或非裔美国人、有心肌梗死、充血性心力衰竭、痴呆症、慢性肺病、轻度肝病、中/重度肝病、肾脏疾病或转移的实体肿瘤病史都与新冠肺炎的死亡几率较高相关。当我们按年龄组对结果进行分层时，合并症与死亡的相关性存在差异。这些发现意味着什么？通过新冠肺炎确定与死亡相关的因素，有助于为临床试验生成假设，并确定可能需要早期干预或监测的患者。这项研究有局限性；例如，在输入数据时，电子医疗记录中可能会漏报或错误编码一些健康状况，并且可能没有涵盖参与者的所有死亡病例。背景：截至2020年6月初，全球报告了近700万例冠状病毒病2019年(新冠肺炎)病例，新冠肺炎携带者中有40多万人死亡。这项研究的目的是确定在美国新冠肺炎患者中，查尔森共病指数中列出的合并症与死亡率之间的关系。方法和研究结果：对来自美国24家医疗机构的成年新冠肺炎患者进行了一项回顾性队列研究。这项研究包括2020年1月20日至2020年5月26日期间，年龄在18岁至90岁之间、电子病历中使用新冠肺炎编码的成年人。结果还按年龄组进行分层(
Author summaryWhy was this study done? Coronavirus disease 2019 (COVID-19) has led to a public health emergency internationally. As of June 2020, there were over 400,000 deaths reported with COVID-19 globally and over 110,000 deaths were in the US, but many people have also recovered. Because of the unprecedented outbreak of COVID-19 worldwide, little is known about which underlying health conditions may impact a person's likelihood of dying with COVID-19. Some previous studies have suggested being older; being from a black, Asian, or minority ethnic (BAME) background; and having certain health conditions may increase risk of death with COVID-19, but further evidence is needed to understand factors which influence this. What did the researchers do and find? The research utilized a network of 24 healthcare organizations in the US, which provided deidentified data from electronic medical records of patients. A total of 31,461 adults with COVID-19 coded in their electronic medical records were included in the study after a search of the network between January 20, 2020, and May 26, 2020. We determined associations between age, sex, ethnicity, comorbidities, and death with COVID-19 during the study period. After accounting for the other included factors in the study, being older, being male, being black or African American, and having a history of myocardial infarction, congestive heart failure, dementia, chronic pulmonary disease, mild liver disease, moderate/severe liver disease, renal disease, or metastatic solid tumor were all associated with higher odds of death with COVID-19. There were differences in which comorbidities were associated with death when we stratified the results by age group. What do these findings mean? Identifying factors associated with death with COVID-19 could help with hypothesis generating for clinical trials and identify patients who may need to be targeted for early intervention or monitoring. The study has limitations; for example, some health conditions may be underreported or incorrectly coded in electronic medical records at the time of data entry, and all deaths of participants may not have been captured.Background At the beginning of June 2020, there were nearly 7 million reported cases of coronavirus disease 2019 (COVID-19) worldwide and over 400,000 deaths in people with COVID-19. The objective of this study was to determine associations between comorbidities listed in the Charlson comorbidity index and mortality among patients in the United States with COVID-19. Methods and findings A retrospective cohort study of adults with COVID-19 from 24 healthcare organizations in the US was conducted. The study included adults aged 18-90 years with COVID-19 coded in their electronic medical records between January 20, 2020, and May 26, 2020. Results were also stratified by age groups (