已入深夜,您辛苦了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!祝你早点完成任务,早点休息,好梦!

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

医学 观察研究 肺炎 大流行 急诊医学 2019年冠状病毒病(COVID-19) 住院 流行病学 死亡率 儿科 内科学 传染病(医学专业) 疾病
作者
NULL AUTHOR_ID,NULL AUTHOR_ID,NULL AUTHOR_ID,Eugene H. Blackstone
出处
期刊:BMJ Open [BMJ]
卷期号:14 (7): e075028-e075028
标识
DOI:10.1136/bmjopen-2023-075028
摘要

Objective In order to predict at hospital admission the prognosis of patients with serious and life-threatening COVID-19 pneumonia, we sought to understand the clinical characteristics of hospitalised patients at admission as the SARS-CoV-2 pandemic progressed, document their changing response to the virus and its variants over time, and identify factors most importantly associated with mortality after hospital admission. Design Observational study using a prospective hospital systemwide COVID-19 database. Setting 15-hospital US health system. Participants 26 872 patients admitted with COVID-19 to our Northeast Ohio and Florida hospitals from 1 March 2020 to 1 June 2022. Main outcome measures 60-day mortality (highest risk period) after hospital admission analysed by random survival forests machine learning using demographics, medical history, and COVID-19 vaccination status, and viral variant, symptoms, and routine laboratory test results obtained at hospital admission. Results Hospital mortality fell from 11% in March 2020 to 3.7% in March 2022, a 66% decrease (p<0.0001); 60-day mortality fell from 17% in May 2020 to 4.7% in May 2022, a 72% decrease (p<0.0001). Advanced age was the strongest predictor of 60-day mortality, followed by admission laboratory test results. Risk-adjusted 60-day mortality had all patients been admitted in March 2020 was 15% (CI 3.0% to 28%), and had they all been admitted in May 2022, 12% (CI 2.2% to 23%), a 20% decrease (p<0.0001). Dissociation between observed and predicted decrease in mortality was related to temporal change in admission patient profile, particularly in laboratory test results, but not vaccination status or viral variant. Conclusions Hospital mortality from COVID-19 decreased substantially as the pandemic evolved but persisted after hospital discharge, eclipsing hospital mortality by 50% or more. However, after accounting for the many, even subtle, changes across the pandemic in patients’ demographics, medical history and particularly admission laboratory results, a patient admitted early in the pandemic and predicted to be at high risk would remain at high risk of mortality if admitted tomorrow.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
zcg完成签到 ,获得积分10
2秒前
默默完成签到 ,获得积分10
2秒前
温柔的柠檬完成签到 ,获得积分10
6秒前
爱学习的YY完成签到 ,获得积分10
9秒前
JiayinLiu完成签到,获得积分20
10秒前
陈补天完成签到 ,获得积分10
14秒前
Shawn完成签到 ,获得积分10
14秒前
江南之南完成签到 ,获得积分10
15秒前
长安完成签到 ,获得积分10
15秒前
回来完成签到,获得积分10
18秒前
19秒前
斯文代梅完成签到,获得积分10
20秒前
辣椒完成签到 ,获得积分10
21秒前
Rondab应助科研通管家采纳,获得10
21秒前
Rondab应助科研通管家采纳,获得10
21秒前
22秒前
aa完成签到,获得积分10
25秒前
汉堡包应助水若琳采纳,获得10
26秒前
fanyueyue完成签到 ,获得积分10
28秒前
4114完成签到,获得积分10
31秒前
ding应助lizigongzhu采纳,获得10
31秒前
32秒前
伊叶之丘完成签到 ,获得积分10
33秒前
SYLH应助WeiMooo采纳,获得10
35秒前
37秒前
38秒前
39秒前
Nefelibata完成签到,获得积分10
39秒前
42秒前
47秒前
Limerencia完成签到,获得积分10
50秒前
李爱国应助zhouleiwang采纳,获得10
55秒前
XL神放完成签到 ,获得积分10
56秒前
稳重向南完成签到,获得积分10
58秒前
范户晓完成签到,获得积分10
1分钟前
1分钟前
kkkk完成签到,获得积分10
1分钟前
冷艳玉米完成签到,获得积分10
1分钟前
kkkk发布了新的文献求助10
1分钟前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
Aktuelle Entwicklungen in der linguistischen Forschung 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989972
求助须知:如何正确求助?哪些是违规求助? 3532034
关于积分的说明 11256042
捐赠科研通 3270884
什么是DOI,文献DOI怎么找? 1805093
邀请新用户注册赠送积分活动 882256
科研通“疑难数据库(出版商)”最低求助积分说明 809216