2020年戈亚斯州住院成人新型冠状病毒肺炎病死率及生存率：一项队列研究
COVID-19 case fatality ratio and survival among hospitalized adults in Goiás, 2020: a cohort study.
作者信息
Borges Moara Alves Santa Bárbara, Zara Ana Laura de Sene Amâncio, Tomich Lísia Gomes Martins de Moura, Guilarde Adriana Oliveira, Oliveira Cacilda Pedrosa de, Carvajal Deborah Lopes Mota, Pedrosa Marina Mascarenhas Roriz, Costa Paulo Sérgio Sucasas da, Turchi Marília Dalva
机构信息
Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brazil.
Universidade Federal de Goiás, Hospital das Clínicas, Serviço de Infectologia, Goiânia, GO, Brazil.
出版信息
Epidemiol Serv Saude. 2025 May 23;34:e20240053. doi: 10.1590/S2237-96222025v34e20240053.en. eCollection 2025.
OBJECTIVE
To describe clinical-epidemiological and therapeutic aspects and to estimate case fatality ratio and risk factors for lower in-hospital survival due to COVID-19.
METHODS
This is a retrospective cohort study conducted in the state of Goiás, Brazil, in 2020, with data obtained from the Influenza Epidemiological Surveillance Information System and through a review of clinical records and hospital. Relative risk for in-hospital death was estimated and Poisson multiple regression and Cox regression analyses were performed. Survival functions were compared using the log-rank test and represented by Kaplan-Meier curves.
RESULTS
The sample consisted of 651 adults, whose median age was 59 years, 57.0% were admitted to public hospitals, 61.1% had severe acute respiratory syndrome on admission and 72.0% had at least one comorbidity, the most frequent being hypertension , diabetes and obesity. The overall case fatality ratio was 17.5% (95% confidence interval, 95%CI 14.7; 20.6), with no significant difference between public and private hospitals. The case fatality ratio was higher in the ≥60 years age group (prevalence ratio, PR 1.26; 95%CI 1.01; 1.58), in hypertensive patients (PR 1.41; 95%CI 1.14; 1 .74) and in those undergoing intensive care (PR 2.68; 95%CI 1.13; 6.32) and mechanical ventilation (PR 11.15; 95%CI 5.53; 22.46). The median time between hospital admission and death was 10 days (interquartile range, 6-18). Survival was lower in the ≥60 years age group (adjusted hazard ratio, HR 1.93; 95%CI 1.26; 2.95) and in those undergoing mechanical ventilation (HR 10.13; 95%CI 6.03; 17. 02).
CONCLUSION
Factors related to comorbidities and severity were independent predictors of shorter in-hospital survival among patients with COVID-19.
目的
描述临床流行病学和治疗方面的情况，并估计2019冠状病毒病（COVID-19）导致住院生存率降低的病死率和危险因素。
方法
这是一项于2020年在巴西戈亚斯州进行的回顾性队列研究，数据来自流感流行病学监测信息系统，并通过查阅临床记录和医院资料获得。估计住院死亡的相对风险，并进行泊松多元回归和Cox回归分析。使用对数秩检验比较生存函数，并用Kaplan-Meier曲线表示。
结果
样本包括651名成年人，中位年龄为59岁，57.0%入住公立医院，61.1%入院时患有严重急性呼吸综合征，72.0%至少有一种合并症，最常见的是高血压、糖尿病和肥胖。总体病死率为17.5%（95%置信区间，95%CI 14.7；20.6），公立医院和私立医院之间无显著差异。≥60岁年龄组的病死率较高（患病率比，PR 1.26；95%CI 1.01；1.58），高血压患者（PR 1.41；95%CI 1.14；1.74）以及接受重症监护的患者（PR 2.68；95%CI 1.13；6.32）和接受机械通气的患者（PR 11.15；95%CI 5.53；22.46）也是如此。住院至死亡的中位时间为10天（四分位间距，6 - 18天）。≥60岁年龄组（调整后风险比，HR 1.93；95%CI 1.26；2.95）和接受机械通气的患者（HR 10.13；95%CI 6.03；17.02）的生存率较低。
结论
合并症和病情严重程度相关因素是COVID-19患者住院生存期较短的独立预测因素。
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