适应世卫组织COVID-19临床进展量表的基于注册表的数据:瑞典的一项全人口研究
Hanna Jerndal1, Sebastian Kalucza1, Frida Jakobsson1
1Department of Clinical Microbiology, Umeå University, Umeå, SE 901 85, Sweden.
Clinical epidemiology
|July 21, 2025
概括
一个新的COVID-19严重程度指数,基于世卫组织规模和注册数据,与90天死亡率相关联. 该工具有助于比较COVID-19研究和公共卫生政策制定.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 基于登记的研究中缺乏标准化的COVID-19严重程度分类,这阻碍了研究比较.
- 世界卫生组织 (WHO) COVID-19 临床进展量表是为临床数据而设计的,而不是健康登记册.
- 需要对注册表数据进行一种新的,适用于国际范围的严重程度分类.
研究的目的:
- 开发和验证一种可适应健康登记数据的新型COVID-19严重性指数.
- 为了实现标准化和可比的基于注册的COVID-19研究.
- 创建一个具有潜在国际适用性的工具.
主要方法:
- 将世卫组织临床进展量表翻译为使用ICD和程序代码的严重性指数.
- 利用来自成年瑞典人口 (2020年1月 - 2022年7月) 的门诊,住院,重症监护和死亡记录数据.
- 应用了考克斯的比例危险模型来评估COVID-19严重程度和死亡率之间的相关性.
主要成果:
- 开发了一个十类COVID-19严重性指数,涵盖超过820万个体,包括近200万个SARS-CoV-2感染.
- 发现90天全因死亡率随严重程度的增加而增加,需要ECMO/ECLS的患者的死亡率最高 (aHR 593.54).
- 调整后的危险比率表明住院患者的死亡率增加 (aHR 5.83),与没有医疗保健接触者 (aHR 1.18) 相比.
结论:
- 新型COVID-19严重程度指数与90天全因死亡率相关,并与现有文献一致.
- 该指数促进了对COVID-19的比较研究,为公共卫生政策和临床指南提供了信息.
- 该工具是一个创新的流行病学资源,有可能用于其他传染病和实时数据建模.
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