Abstract：
OBJECTIVE: To describe the predictors of mortality in hospitalized patients with severe acute respiratory syndrome (SARS) due to COVID-19 presenting with silent hypoxemia.
METHODS: Retrospective cohort study of hospitalized patients with SARS due to COVID-19 and silent hypoxemia at admission, in Brazil, from January to June 2021. The primary outcome of interest was in-hospital death. Multivariable logistic regression analysis was performed.
RESULTS: Of 46,102 patients, the mean age was 59 ± 16 years, and 41.6% were female. During hospitalization, 13,149 patients died. Compared to survivors, non-survivors were older (mean age, 66 vs. 56 years; P < 0.001), less frequently female (43.6% vs. 40.9%; P < 0.001), and more likely to have comorbidities (74.3% vs. 56.8%; P < 0.001). Non-survivors had higher needs for invasive mechanical ventilation (42.4% vs. 6.6%; P < 0.001) and intensive care unit admission (56.9% vs. 20%; P < 0.001) compared to survivors. In the multivariable regression analysis, advanced age (OR 1.04; 95%CI 1.037-1.04), presence of comorbidities (OR 1.54; 95%CI 1.47-1.62), cough (OR 0.74; 95%CI 0.71-0.79), respiratory distress (OR 1.32; 95%CI 1.26-1.38), and need for non-invasive respiratory support (OR 0.37; 95%CI 0.35-0.40) remained independently associated with death.
CONCLUSIONS: Advanced age, presence of comorbidities, and respiratory distress were independent risk factors for mortality, while cough and requirement for non-invasive respiratory support were independent protective factors against mortality in hospitalized patients due to SARS due to COVID-19 with silent hypoxemia at presentation.
METHODS: Retrospective cohort study of hospitalized patients with SARS due to COVID-19 and silent hypoxemia at admission, in Brazil, from January to June 2021. The primary outcome of interest was in-hospital death. Multivariable logistic regression analysis was performed.
RESULTS: Of 46,102 patients, the mean age was 59 ± 16 years, and 41.6% were female. During hospitalization, 13,149 patients died. Compared to survivors, non-survivors were older (mean age, 66 vs. 56 years; P < 0.001), less frequently female (43.6% vs. 40.9%; P < 0.001), and more likely to have comorbidities (74.3% vs. 56.8%; P < 0.001). Non-survivors had higher needs for invasive mechanical ventilation (42.4% vs. 6.6%; P < 0.001) and intensive care unit admission (56.9% vs. 20%; P < 0.001) compared to survivors. In the multivariable regression analysis, advanced age (OR 1.04; 95%CI 1.037-1.04), presence of comorbidities (OR 1.54; 95%CI 1.47-1.62), cough (OR 0.74; 95%CI 0.71-0.79), respiratory distress (OR 1.32; 95%CI 1.26-1.38), and need for non-invasive respiratory support (OR 0.37; 95%CI 0.35-0.40) remained independently associated with death.
CONCLUSIONS: Advanced age, presence of comorbidities, and respiratory distress were independent risk factors for mortality, while cough and requirement for non-invasive respiratory support were independent protective factors against mortality in hospitalized patients due to SARS due to COVID-19 with silent hypoxemia at presentation.
摘要：
目的：描述因COVID-19表现为无症状低氧血症的严重急性呼吸综合征（SARS）住院患者死亡率的预测因素。
方法：对因COVID-19和无症状性低氧血症引起的SARS住院患者进行回顾性队列研究，在巴西,2021年1月至6月。感兴趣的主要结果是住院死亡。进行多变量logistic回归分析。
结果：在46,102名患者中，平均年龄为59±16岁，41.6%为女性。住院期间,13149名患者死亡。与幸存者相比，非幸存者年龄较大(平均年龄，66vs.56岁；P<0.001），女性频率较低(43.6%vs.40.9%；P<0.001），更有可能有合并症(74.3%vs.56.8%；P<0.001）。与幸存者相比，非幸存者对有创机械通气（42.4％vs6.6％；P<0.001）和重症监护病房入院（56.9％vs20％；P<0.001）的需求更高。在多元回归分析中，高龄（OR1.04；95CI1.037-1.04），存在合并症（OR1.54；95CI1.47-1.62），咳嗽（OR0.74；95CI0.71-0.79），呼吸窘迫（OR1.32；95CI1.26-1.38），并且需要无创呼吸支持(OR0.37;95CI0.35-0.40)仍然与死亡独立相关.
结论：高龄，合并症的存在，呼吸窘迫是死亡的独立危险因素,而咳嗽和需要无创呼吸支持是住院患者因COVID-19出现时无症状低氧血症导致SARS死亡的独立保护因素。
方法：对因COVID-19和无症状性低氧血症引起的SARS住院患者进行回顾性队列研究，在巴西,2021年1月至6月。感兴趣的主要结果是住院死亡。进行多变量logistic回归分析。
结果：在46,102名患者中，平均年龄为59±16岁，41.6%为女性。住院期间,13149名患者死亡。与幸存者相比，非幸存者年龄较大(平均年龄，66vs.56岁；P<0.001），女性频率较低(43.6%vs.40.9%；P<0.001），更有可能有合并症(74.3%vs.56.8%；P<0.001）。与幸存者相比，非幸存者对有创机械通气（42.4％vs6.6％；P<0.001）和重症监护病房入院（56.9％vs20％；P<0.001）的需求更高。在多元回归分析中，高龄（OR1.04；95CI1.037-1.04），存在合并症（OR1.54；95CI1.47-1.62），咳嗽（OR0.74；95CI0.71-0.79），呼吸窘迫（OR1.32；95CI1.26-1.38），并且需要无创呼吸支持(OR0.37;95CI0.35-0.40)仍然与死亡独立相关.
结论：高龄，合并症的存在，呼吸窘迫是死亡的独立危险因素,而咳嗽和需要无创呼吸支持是住院患者因COVID-19出现时无症状低氧血症导致SARS死亡的独立保护因素。
