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.
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。