Mortality and survival of COVID-19
Mortality and survival of COVID-19
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DOI：
10.1017/s0950268820001405
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Pereira, M. L. D.
中科院分区：
文献类型：
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作者：
Sousa, G. J. B.;Garces, T. S.;Pereira, M. L. D.
本研究旨在确定与巴西东北部一个州COVID-19病例死亡率和生存率相关的危险因素。这是一个具有二级数据库的历史队列，其中有2070人出现流感样症状，在该州寻求卫生援助，并在2020年4月14日之前检测出COVID-19阳性，只有中度和重度病例住院治疗。主要结果是死亡作为一个二元变量（是/否）。它还调查了与该病死亡率和生存率有关的主要因素。从症状开始到死亡/调查结束（2020年4月14日）的时间是本研究的时间变量。死亡率采用稳健泊松回归分析，生存率采用Kaplan-Meier和Cox回归分析。在2070例新冠病毒检测呈阳性的病例中，死亡131例（6.3%），存活1939例（93.7%），从感染第24天起，总生存率为87.7%。死亡率因以下变量而增加：老年人（风险比3.6;95% CI 2.3-5.8；P< 0.001）、神经系统疾病（风险比3.9;95% CI 1.9-7.8；P< 0.001）、肺病（风险比2.6;95% CI 1.4-4.7；P< 0.001）和心血管疾病（风险比8.9;95% CI 5.4-14.5；P< 0.001）。综上所述，尽管死亡发生较晚，但西非地区COVID-19的死亡率与该疾病病例大量的国家相似。老年人和合并症表现出更大的死亡风险。
This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8;P< 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8;P< 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7;P< 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5;P< 0.001). In conclusion, mortality by COVID-19 in Ceara is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.