评估住院数据作为COVID-19严重性指标:卡塔尔的国家评估
Layan Sukik1, Hiam Chemaitelly1,2, Houssein H Ayoub3
1Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
Open forum infectious diseases
|March 17, 2025
概括
住院治疗COVID-19并不是真正感染严重程度的可靠指标. 重症监护室 (ICU) 的入院患者显示出更好的,但仍然有限的,测量严重疾病的准确性.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 准确评估SARS-CoV-2感染严重程度对于了解疾病影响和干预效果至关重要.
- 这项研究评估了与SARS-CoV-2相关的住院治疗的可靠性,以衡量真正的COVID-19严重程度.
研究的目的:
- 为了确定与SARS-CoV-2相关的急诊或ICU病床住院是否可靠地表明真正的COVID-19严重程度.
- 根据世卫组织的标准,比较一般住院病人的诊断准确度与仅在ICU住院病人的诊断准确度.
主要方法:
- 从2021年9月到2024年5月,对卡塔尔644,176例SARS-CoV-2感染病例进行了回顾性分析.
- 评估了两个指标的诊断准确性: (1) 任何住院 (急诊或ICU) 和 (2) 仅在ICU住院.
- 作为参考标准,使用了严重,危急和致命的COVID-19的世卫组织标准.
主要成果:
- 任何住院治疗都显示出与世卫组织标准的差异一致 (kappa=0.17),尽管有很高的百分比一致 (98.7%).
- 仅在重症监护室住院的病例与世卫组织标准相对一致 (kappa=0.47).
- 对于这两个指标,敏感度和正预测值 (PPV) 都很低,特别是对于一般住院治疗 (PPV=9.7%).
结论:
- 在评估COVID-19的严重程度时,一般医院的入院是不可靠的.
- 集中治疗室的入院提供了一个更准确的,虽然仍然不完美的,严重的COVID-19的衡量标准.
- 使用特定的标准,如世卫组织的指导方针,至关重要,以尽量减少流行病学和疫苗有效性研究的偏见.
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