The Impact of Asthma on Mortality in Patients With COVID-19.
The Impact of Asthma on Mortality in Patients With COVID-19.
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DOI：
10.1016/j.chest.2020.05.575
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发表时间：
2020-12
期刊：
影响因子：
9.6
通讯作者：
Taioli E
中科院分区：
文献类型：
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作者：
Lieberman-Cribbin W;Rapp J;Alpert N;Tuminello S;Taioli E
方法从MSHS新冠肺炎注册中心下载匿名数据，选择急诊和住院患者。该数据集包含患者的人口统计数据、居住地、到达医院时的生命体征以及入院时的处方药。用鼻咽拭子上的逆转录-聚合酶链式反应证实了新冠肺炎的结果。在测试时自我报告有哮喘史。这项研究的主要结果是死亡率。相关联合创始人包括入院时的患者特征和新冠肺炎状态。需要3814名患者的样本大小来检测哮喘和死亡率之间的关联，假设效应大小为3%，显著性水平为0.05，力量为80%。所有分析均在SASv9中进行。4(SAS研究所)。这项研究经过了西奈山机构审查委员会的审查，并被认为是豁免的。结果共有11,405名患者在MSHS内经历了与新冠肺炎相关的医院遭遇(2020年2月29日至2020年4月24日)。在这些人中，54.8%的人确认了新冠肺炎，45.2%的人新冠肺炎检测为阴性。51%的患者是女性，主要是非白人(72.2%)，年龄中值为57岁(四分位数范围，33岁)；患者的居住区主要是曼哈顿(42.1%)、布鲁克林(24.5%)和皇后区(18.9%)。618名患者(5.4%)有哮喘症状，其中使用新冠肺炎的患者占4.4%，未使用新冠肺炎的患者占6.8%(P<；0001)。居住在布朗克斯的患者哮喘患病率为8.8%，曼哈顿为7.6%，斯塔顿岛为4.6%，皇后区为4.0%。有哮喘史的患者年龄在40岁至69岁之间(48.6%)，40岁(28.3%)，69岁(23.1%)。
MethodsAnonymous data from the MSHS COVID-19 registry were downloaded, and ED and inpatient encounters were selected. This dataset contained patient demographics, borough of residence, vitals on arrival to the hospital, and prescribed medications during hospital admission. COVID-19 results were confirmed using reverse transcription polymerase chain reaction on nasopharyngeal swabs. A history of asthma was self-reported at the time of testing. The main outcome in this study was mortality. Relevant cofounders included patient characteristics at admission and COVID-19 status. A sample size of 3,814 patients was needed to detect an association between asthma and mortality with 80% power, assuming an effect size of 3%, and a significance level of 0.05. All analyses were performed in SAS v9. 4 (SAS Institute). This study was reviewed by the institutional review board of Mount Sinai and considered exempt.ResultsThere were 11,405 patients who experienced a COVID-19-related hospital encounter within the MSHS (February 29, 2020-April 24, 2020). Of these, 54.8% had confirmed COVID-19 and 45.2% had a COVID-19-negative test. Fifty-one percent of patients were women, mostly nonwhite (72.2%), with a median age of 57 years (interquartile range, 33); the patient’s borough of residence was mostly Manhattan (42.1%), Brooklyn (24.5%), and Queens (18.9%). Asthma was self-reported by 618 patients (5.4%), including 4.4% of the patients with COVID-19, and 6.8% of the patients without COVID-19 (P<. 0001). Asthma prevalence was 8.8% in patients living in the Bronx, 7.6% in Manhattan, 4.6% in Staten Island, and 4.0% in Queens. Patients with an asthma history were between the ages of 40 and 69 years (48.6%),< 40 years (28.3%), and> 69 years (23.1%).