Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study.
Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study.
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DOI：
10.2147/idr.s405256
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发表时间：
2023
影响因子：
3.9
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中科院分区：
文献类型：
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关于非洲因严重 2019 年冠状病毒病 (COVID-19) 住院的青壮年患者的数据很少。在这项研究中，我们描述了乌干达 18 至 49 岁重症 COVID-19 患者的临床特征和 30 天生存率。我们审查了乌干达五个 COVID-19 治疗单位 (CTU) 收治的重症 COVID-19 患者的治疗记录。我们纳入了年龄在 18 岁至 49 岁之间、检测结果呈阳性或符合 COVID-19 临床标准的个体。我们将重症 COVID-19 定义为氧饱和度 <94%、影像学显示肺部浸润 >50% 以及存在需要入住 CTU 的合并症。我们的主要结果是入院后 30 天的生存率。我们使用 Cox 比例风险模型来确定与 30 天生存率相关的因素（显着性水平为 5%）。在审查的 246 份患者档案中，50.8% (n = 125) 为男性，平均±（标准差）年龄为 39 ± 8 岁，大多数表现为咳嗽，85.8% (n = 211)，中位 C 反应蛋白（四分位距）为 48 (47.5, 178.8) mg/L。 30 天死亡率为 23.9% (59/246)。入院时，贫血（风险比 (HR)：3.00，95% 置信区间 (CI)，1.32–6.82；p = 0.009）和精神状态改变 (GCS <15)（HR：6.89，95% CI：1.48–32.08，p = 0.014）是 30 天死亡率的显着预测因素。乌干达患有重症 COVID-19 的青壮年 30 天死亡率很高。需要对贫血和意识改变进行早期识别和有针对性的管理，以改善临床结果。
There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32–6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48–32.08, p = 0.014) were significant predictors of 30-day mortality. There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.