美国退伍军人与风险匹配比较者中COVID-19感染后的晚期死亡率:为期2年的队列分析
Theodore J Iwashyna1,2,3,4, Sarah Seelye1, Theodore S Berkowitz5
1Veterans Affairs (VA) Center for Clinical Management Research, Ann Arbor VA, Ann Arbor, Michigan.
JAMA internal medicine
|August 21, 2023
概括
COVID-19幸存者最初面临更高的死亡率,但过度死亡风险在180天后显著减少. 这项研究追踪了两年来美国退伍军人COVID-19感染后的死亡率.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 传染性疾病 传染性疾病
背景情况:
- 越来越多的证据表明,在急性COVID-19之后,持续存在的健康问题.
- 与COVID-19相关的长期死亡风险在很大程度上是未知的.
研究的目的:
- 为了量化COVID-19感染后过度死亡风险的持续时间.
- 随着时间的推移,比较感染者与未感染者之间的死亡率.
主要方法:
- 美国退伍军人患有COVID-19的回顾性队列研究 (2020年3月至2021年4月).
- 感染的个体与多达五个未感染的对照者进行了匹配.
- 在感染后730天的间隔内,使用Cox回归来评估死亡率.
主要成果:
- 分析了超过208,000个COVID-19病例和超过100万个比较器.
- 对死亡率的调整后危险比为整体2.01.
- 过度死亡率在前90天 (aHR,6.36) 和91-180天 (aHR,1.18) 中最高.
- 死亡风险不再从感染后的181天增加到730天.
结论:
- 虽然COVID-19最初会增加死亡风险,但这种过度风险在180天内就会消失.
- 长期跟踪表明,在六个月后,COVID-19幸存者的死亡率没有持续增加.
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