Trends Over Time in the Risk of Adverse Outcomes Among Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection
| العنوان: | Trends Over Time in the Risk of Adverse Outcomes Among Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection |
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| المؤلفون: | Emily Locke, Vincent S. Fan, McKenna C Eastment, Kristina Crothers, Kristin Berry, George N. Ioannou, Pamela Green, Ann M. O’Hare, Javeed A. Shah, Jason A. Dominitz |
| المصدر: | Clinical Infectious Diseases. 74:416-426 |
| بيانات النشر: | Oxford University Press (OUP), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Microbiology (medical), Mechanical ventilation, medicine.medical_specialty, business.industry, medicine.medical_treatment, Incidence (epidemiology), Hydroxychloroquine, 030204 cardiovascular system & hematology, Azithromycin, Intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, law, Internal medicine, medicine, 030212 general & internal medicine, business, Veterans Affairs, Dialysis, Dexamethasone, medicine.drug |
| الوصف: | Background We aimed to describe trends in adverse outcomes among patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between February and September 2020 within a national healthcare system. Methods We identified enrollees in the national United States Veterans Affairs healthcare system who tested positive for SARS-CoV-2 between 28 February 2020 and 30 September 2020 (n = 55 952), with follow-up extending to 19 November 2020. We determined trends over time in incidence of the following outcomes that occurred within 30 days of testing positive: hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death. Results Between February and July 2020, there were marked downward trends in the 30-day incidence of hospitalization (44.2% to 15.8%), ICU admission (20.3% to 5.3%), mechanical ventilation (12.7% to 2.2%), and death (12.5% to 4.4%), which subsequently plateaued between July and September 2020. These trends persisted after adjustment for sociodemographic characteristics, comorbid conditions, documented symptoms, and laboratory tests, including among subgroups of patients hospitalized, admitted to the ICU, or treated with mechanical ventilation. From February to September, there were decreases in the use of hydroxychloroquine (56.5% to 0%), azithromycin (48.3% to 16.6%), vasopressors (20.6% to 8.7%), and dialysis (11.6% to 3.8%) and increases in the use of dexamethasone (3.4% to 53.1%), other corticosteroids (4.9% to 29.0%), and remdesivir (1.7% to 45.4%) among hospitalized patients. Conclusions The risk of adverse outcomes in SARS-CoV-2–positive patients decreased markedly between February and July, with subsequent stabilization from July to September. These trends were not explained by changes in measured baseline patient characteristics and may reflect changing treatment practices or viral pathogenicity. |
| تدمد: | 1537-6591 1058-4838 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::7e1b0122f1100dc024bf942d0715e678 https://doi.org/10.1093/cid/ciab419 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........7e1b0122f1100dc024bf942d0715e678 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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