2020 年初密歇根州弗林特市一家社区医院重症监护室 (ICU) 收治的 COVID-19 肺炎患者:特征和死亡率。

Spartan medical research journal Pub Date : 2023-12-05 eCollection Date: 2023-01-01
Atefeh Kalantary, Olga J Santiago-Rivera, Arunima Dutta, Chace Davies, Bilal Malik, Parul Sud, Ibrahim Al-Sanouri
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摘要

简介尽管对影响 COVID-19 患者死亡率的因素进行了许多研究,但关于种族作为风险因素的作用仍存在争论。一些研究报告称,密歇根州的 COVID-19 病例存在地域和种族差异。本研究旨在调查密歇根州弗林特市一家社区教学医院 2020 年收治的第一批重症监护室(ICU)COVID-19 患者的特征,并确定与重症监护室死亡率相关的因素,包括种族因素:这项横断面研究纳入了 2020 年 3 月至 5 月期间入住 ICU 的 COVID-19 重症肺炎成人患者(≥ 18 岁)。与ICU死亡率相关的潜在风险因素包括人口统计学特征、合并症、治疗和并发症:研究样本包括 N = 48 名患者,年龄在 24-85 岁之间(平均 59.7 岁;SD = 12.8);56.2%(n=27)为男性,51.1%(n=24)为黑人成年人。死亡率为 51.1%。在该研究样本中,年龄(aOR 1.1,95% CI [1.01,1.20];p =0.03)、2 型糖尿病(aOR 5.7,95% CI [1.2,29.1];p =0.03)和原发性高血压(aOR 6.2,95% CI [1.1,34.5];p =0.04)均与 ICU 死亡率风险增加有显著的统计学独立关联。另一方面,种族与重症监护病房死亡率无关:这些研究结果支持有关合并症(包括 2 型糖尿病和高血压)与重症 COVID-19 肺炎 ICU 住院患者较差预后相关的文献。这项研究有助于我们深入了解密歇根州弗林特市 COVID-19 大流行早期 ICU 患者群的死亡率。
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Patients with COVID-19 Pneumonia Admitted to an Intensive Care Unit (ICU) at a Community Hospital in Flint, Michigan, in Early 2020: Characteristics and Mortality.

Introduction: Despite the many studies conducted on the factors affecting mortality in patients with COVID-19, there is ongoing debate about the role of race as a risk factor. Several studies have reported a geographic and racial disparity in COVID-19 cases in Michigan. This study aimed to examine the characteristics of the 2020 first cohort of Intensive Care Unit (ICU) COVID-19 patients admitted to a community teaching hospital in Flint, Michigan, and to determine the factors associated with ICU mortality, including race.

Methods: This cross-sectional study included adult patients (≥ 18 years) with severe COVID-19 pneumonia admitted to the ICU between March and May 2020. Potential risk factors associated with ICU mortality included demographic characteristics, comorbidities, treatments, and complications.

Results: The study sample consisted of N = 48 patients, aged 24-85 years, (mean 59.7; SD = 12.8); 56.2% (n=27) were male and 51.1% (n=24) were Black adults. The mortality rate was 51.1%. Age (aOR 1.1, 95% CI [1.01, 1.20]; p =0.03), type 2 diabetes (aOR 5.7, 95% CI [1.2, 29.1]; p =0.03), and essential hypertension (aOR 6.2, 95% CI [1.1, 34.5]; p =0.04) were all found to have statistically significant independent associations with increased risk of ICU mortality in this study sample. On the other hand, race was not found to be associated with ICU mortality.

Conclusions: These findings support the literature regarding the association of comorbid conditions, including type 2 diabetes and hypertension, with poorer outcomes in ICU hospitalized patients with severe COVID-19 pneumonia. This study provides insight into mortality of an ICU patient cohort earlier on during the COVID-19 pandemic in Flint, Michigan.

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