Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination
Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination
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DOI：
10.1111/cei.13507
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发表时间：
2020-09-17
影响因子：
4.6
通讯作者：
Ozkan, P.
中科院分区：
文献类型：
--
作者：
Aksu, K.;Naziroglu, T.;Ozkan, P.
背景各国卡介苗接种政策对新冠肺炎暴发过程的影响是一个令人好奇的问题。本研究探讨卡介苗接种状况与新冠肺炎肺炎病情严重程度的关系及影响病情严重程度的因素。方法对土耳其伊斯坦布尔一家公立医院2020年3月至6月间确诊的新冠肺炎肺炎患者进行回顾性横断面研究，鼻咽标本冠状病毒2型聚合酶链式反应阳性，胸部CT肺浸润物确诊。对受试者的社会人口学特征、体重指数、吸烟状况、伴发疾病、收入水平、卡介苗接种情况等进行分析。结果研究人群包括123例成人新冠肺炎肺炎患者[平均年龄49中心点7岁，标准差=13中心点3年；男性82例(66中心点7%)]。重症患者接种卡介苗的比例较低(68中心点5对88中心点2%，P=0中心点026)，平均年龄(54中心点5年+/-11中心点5年，38中心点3+/-10中心点7年；P<；0中心点001)，糖尿病(32中心点6对5中心点9%，P=0中心点002)和低收入(84中心点3对52中心点9%，P<；0中心点001)高于轻症患者。多因素分析显示，年龄增大[优势比(OR)=1中心点119；95%可信区间(CI)=1中心点062-1中心点178，P<；0中心点001]和低收入(OR=3中心点209；95%CI=1中心点008-10中心点222，P=0中心点049)与新冠肺炎肺炎病情严重有关。结论新冠肺炎肺炎患者接种卡介苗与病情严重程度无关。年龄和低收入是严重新冠肺炎肺炎的主要决定因素。
Background The impact of countries' bacillus Calmette-Guerin (BCG) vaccination policies on the course of coronavirus disease (COVID-19) outbreak is a curiosity. In this study, the relationship between BCG vaccination status and severity of COVID-19 pneumonia and the factors affecting disease severity were investigated. Methods A retrospective cross-sectional study was conducted between March and June 2020 in patients diagnosed with COVID-19 pneumonia, confirmed by severe acute respiratory syndrome coronavirus-2 polymerase chain reaction positivity in a nasopharyngeal sample and pulmonary infiltrates in computed chest tomography, in a state hospital in Istanbul, Turkey. Socio-demographic features, body mass index, smoking status, concomitant diseases, income rates and BCG vaccination status of subjects were analyzed. Result The study population comprised 123 adults with COVID-19 pneumonia [mean age = 49 center dot 7 years, standard deviation = 13 center dot 3 years; 82 (66 center dot 7%) male]. While the rate of cases vaccinated with BCG is lower (68 center dot 5versus88 center dot 2%,P = 0 center dot 026), mean age (54 center dot 0 +/- 11 center dot 5 yearsversus38 center dot 3 +/- 10 center dot 7 years;P < 0 center dot 001), diabetes (32 center dot 6versus5 center dot 9%,P = 0 center dot 002) and low income (84 center dot 3versus52 center dot 9%,P < 0 center dot 001) are higher in patients with severe disease compared to those with mild disease. According to multivariate analysis increasing age [odds ratio (OR) = 1 center dot 119; 95% confidence interval (CI) = 1 center dot 062-1 center dot 178,P < 0 center dot 001] and low income (OR = 3 center dot 209; 95% CI = 1 center dot 008-10 center dot 222,P = 0 center dot 049) are associated with severe disease in COVID-19 pneumonia. Conclusion This study reveals that BCG vaccination is not associated with disease severity in COVID-19 pneumonia. Age and low income are the main determinants of severe COVID-19 pneumonia.