Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario
Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario
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DOI：
10.1016/j.jcv.2020.104338
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发表时间：
2020-05-01
影响因子：
8.8
通讯作者：
Mubareka, Samira
中科院分区：
文献类型：
--
作者：
Kozak, Robert;Prost, Karren;Mubareka, Samira
背景：世界卫生组织强调需要改进对非流感RNA呼吸道病毒造成的健康负担的监测和了解。人类冠状病毒(CoV)是呼吸道和胃肠道感染的主要原因，具有相关的发病率和死亡率。目的：本研究的目的是了解我们三级护理中心CoV的流行病学特征，并确定疾病严重程度的临床相关性。研究设计：对2010年至2016年间收治的226例确诊为CoV呼吸道感染的患者进行横断面研究。结果：冠状病毒占所有呼吸道病毒阳性样本的11.3%，OC43是最常见的冠状病毒。大多数感染与社区有关，21.6%被认为是医院感染。平均住院时间为11.8天，17.3%的患者需要入住ICU，全因死亡率为7%。在多变量模型中，女性性别和吸烟与ICU入院或死亡的可能性增加相关。结论：这项研究强调了CoVS的重大负担，并证明了在急性护理环境中进行监测的必要性。
Background: The World Health Organization has highlighted the need for improved surveillance and understanding of the health burden imposed by non-influenza RNA respiratory viruses. Human coronaviruses (CoVs) are a major cause of respiratory and gastrointestinal tract infections with associated morbidity and mortality.Objectives: The objective of our study was to characterize the epidemiology of CoVs in our tertiary care centre, and identify clinical correlates of disease severity.Study design: A cross-sectional study was performed of 226 patients admitted with confirmed CoV respiratory tract infection between 2010 and 2016. Variables consistent with a severe disease burden were evaluated including symptoms, length of stay, intensive care unit (ICU) admission and mortality.Results: CoVs represented 11.3% of all positive respiratory virus samples and OC43 was the most commonly identified CoV. The majority of infections were community-associated while 21.6% were considered nosocomial. The average length of stay was 11.8 days with 17.3% of patients requiring ICU admission and an all-cause mortality of 7%. In a multivariate model, female gender and smoking were associated with increased likelihood of admission to ICU or death.Conclusion: This study highlights the significant burden of CoVs and justifies the need for surveillance in the acute care setting.