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Su-Boon Yong1,2, Shuo-Yan Gau3, Chia-Jung Li4
1Department of Allergy and Immunology, China Medical University Children's Hospital, Taichung, Taiwan.
Frontiers in pharmacology
|November 29, 2023
概括
使用吸入性皮质类固醇 (ICS) 的喘患者的COVID-19发病率较高,但住院治疗,急诊和死亡风险较低. 这一发现为喘患者管理COVID-19风险提供了指导.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 临床流行病学临床流行病学
背景情况:
- 喘,COVID-19和吸入性皮质类固醇 (ICS) 使用对患者结果的相互作用尚未得到充分理解.
- 喘管理通常涉及ICS,需要明确它们在COVID-19方面的作用.
- 现有的研究缺乏基于ICS利用的COVID-19风险和喘患者的结果的综合数据.
研究的目的:
- 为了调查COVID-19在喘患者中与ICS使用和不使用的发病率.
- 评估ICS在喘患者的使用与COVID-19相关结果之间的关联,包括住院治疗,急诊室访问和死亡率.
- 为在COVID-19大流行期间管理喘患者的医疗保健提供者提供基于证据的见解.
主要方法:
- 使用 TriNetX 网络,一个联合的健康数据网络的回顾性队列研究.
- 纳入标准:2020年1月至2022年12月期间被诊断患有喘的患者,按ICS使用 (用户与非用户) 分类.
- 倾向性得分匹配用于创建可比的队列,用于COVID-19发病率和医疗利用的风险评估.
主要成果:
- 使用ICS的喘患者表现出更高的COVID-19发病率 (HR: 1.383,95%CI: 1.330-1.437).
- 相反,ICS用户显示住院 (HR:0.664),急诊室访问 (HR:0.774) 和死亡率 (HR:0.834) 的风险明显较低.
- 亚组和敏感性分析考虑了疫苗接种状态,疾病严重程度和COVID-19变种.
结论:
- 与非使用者相比,ICS上的喘患者面临着明显增加的COVID-19感染风险.
- 尽管感染率较高,但在喘患者中使用ICS与住院治疗,急救诊所访问和死亡率等严重结果的减少有关.
- 这些发现可能会为初级保健医生提供评估和管理喘患者群体中COVID-19风险的信息.
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