背景:2020年,2019年重症冠状病毒病(COVID-19)患者在全球范围内的28天死亡率为30%至50%;香港此类患者的结局未知。这项研究调查了香港重症或重症COVID-19患者的28天死亡率和相应的危险因素。
方法:这项回顾性队列研究纳入了2020年1月22日至9月30日在香港三家公立医院收治的重症或危重症COVID-19成年患者。人口统计,合并症,症状,治疗,并对结果进行了检查。
结果:在125例重症或危重症COVID-19患者中,有15例(12.0%)在28天内死亡。总的来说,患者年龄中位数为64岁;48.0%和54.4%的患者有高血压和肥胖,分别。在中位数为3天后,呼吸道样本被证实为严重急性呼吸综合征冠状病毒2RNA阳性。最常见的症状是发热(80.0%的患者);45.6%和32.8%的患者在重症监护病房接受治疗并需要机械通气,分别。在比较28天幸存者和非幸存者的逻辑回归分析中,与28天死亡率增加相关的因素是年龄(年龄每增加1年的比值比[OR]=1.12,95%置信区间[CI]=1.04-1.21;P=0.002),卒中病史(OR=15.96,95%CI=1.65-154.66;P=0.017),使用肾脏替代治疗(OR=15.32,95%CI=2.67-87.83;P=0.002),洛匹那韦-利托那韦治疗持续时间较短(每1天增加OR=0.82,95%CI=0.68-0.98;P=0.034)。
结论:香港重症或重症COVID-19患者的28天死亡率为12.0%。年纪大了,中风史,使用肾脏替代疗法,洛匹那韦-利托那韦治疗持续时间较短是28天死亡率的独立预测因素。
In 2020, patients with critical coronavirus disease 2019 (COVID-19) had a 28-day mortality rate of 30% to 50% worldwide; outcomes among such patients in Hong Kong were unknown. This study investigated 28-day mortality and corresponding risk factors among patients with severe or critical COVID-19 in Hong Kong.
This retrospective cohort study included adult patients with severe or critical COVID-19 who were admitted to three public hospitals in Hong Kong from 22 January to 30 September 2020. Demographics, comorbidities, symptoms, treatment, and outcomes were examined.
Among 125 patients with severe or critical COVID-19, 15 (12.0%) died within 28 days. Overall, the median patient age was 64 years; 48.0% and 54.4% of patients had hypertension and obesity, respectively. Respiratory samples were confirmed severe acute respiratory syndrome coronavirus 2 RNA-positive after a median of 3 days. The most common presenting symptom was fever (80.0% of patients); 45.6% and 32.8% of patients received care in intensive care unit and required mechanical ventilation, respectively. In logistic regression analysis comparing 28-day survivors and non-survivors, factors associated with greater 28-day mortality were older age (odds ratio [OR] per 1-year increase in age=1.12, 95% confidence interval [CI]=1.04-1.21; P=0.002), history of stroke (OR=15.96, 95% CI=1.65-154.66; P=0.017), use of renal replacement therapy (OR=15.32, 95% CI=2.67-87.83; P=0.002), and shorter duration of
lopinavir-ritonavir treatment (OR per 1-day increase=0.82, 95% CI=0.68-0.98; P=0.034).
The 28-day mortality rate among patients with severe or critical COVID-19 in Hong Kong was 12.0%. Older age, history of stroke, use of renal replacement therapy, and shorter duration of
lopinavir-ritonavir treatment were independent predictors of 28-day mortality.