在丹麦接受重症监护的COVID-19患者的长期结果:一项全国性的观察性研究
Nick Meier1, Anders Perner1, Ronni Plovsing2
1Department of Intensive Care, Rigshospitalet, Copenhagen, Denmark.
Acta anaesthesiologica Scandinavica
|June 8, 2023
概括
丹麦的COVID-19重症监护室 (ICU) 结果显示,生命支持使用量下降,但在三个波中死亡率保持不变. 接种疫苗的ICU患者经历了严重的疾病,Omicron变种的出现改变了治疗模式.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 随着COVID-19重症监护室 (ICU) 患者结果的不断变化,资源的利用以及病毒遗传变异和疫苗接种状态的影响仍然不完全理解.
- 需要长度数据来跟踪随着时间的推移对COVID-19患者的重症监护的变化.
研究的目的:
- 分析2020年3月至2022年3月期间丹麦COVID-19重症监护室患者人口统计,资源使用和死亡率的趋势.
- 基于入院期和疫苗接种状态来比较结果,并描述与Omicron变种相关的流行病学转变.
主要方法:
- 从2020年3月10日至2022年3月31日期间诊断出COVID-19的2167名丹麦ICU患者的医疗记录中手动检索数据.
- 数据包括人口统计,并发病,疫苗接种情况,生命支持利用率,停留时间和生命状态.
- 基于三个入院波和疫苗接种状态的比较分析;描述了Omicron变种期间的变化.
主要成果:
- 在使用侵入性机械通风 (81%至51%),替代疗法 (26%至12%) 和体外膜氧化 (7%至2%) 的三个波段中观察到显著下降.
- 集中治疗室停留时间和机械通风的持续时间也减少了,而90天死亡率仍然很高 (33-36%).
- 与一般人口 (80%) 相比,ICU患者的疫苗接种率较低 (42%);未接种疫苗的患者年轻,并发病率较少,但死亡率较高 (29%对51%).
结论:
- 尽管生命支持使用量下降,但丹麦COVID-19重症监护室患者的90天死亡率在研究波中保持不变.
- 接种疫苗的ICU患者代表了重病队列,表明疫苗接种并没有预防这一群体的危急疾病.
- 奥米克朗变种的出现与减少使用COVID特定治疗方法相关,这表明ICU入院标准或患者个人资料的转变.
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