文摘
摘要目的:由28天来确定重要疾病的几率和持续时间的机械通气(MV)超过45天的观察期患者脑血管疾病和COVID-19的历史。
背景:COVID-19-associated发病率与多个因素,包括年龄、并存病,病毒和宿主反应。我们理解重要疾病的风险由于之前神经疾病仍然有限。在这里,我们假设在脑血管疾病COVID-19严重后果的危险因素,包括增加MV的持续时间。
设计/方法:连续横断面研究1128成人患者承认高等护理中心在波士顿,马萨诸塞州,并与实验室确认的COVID-19诊断。脑血管疾病史之间的关系和重要的疾病定义为MV或死亡是检查使用逻辑回归和逆概率加权的倾向得分。累积成功拔管的发生率没有死亡超过45天使用竞争风险分析研究。
结果:的1128名成年人与COVID-19承认,350年(36%)被28天病危。中位数年龄为59岁(标准差:18年),640(57%)是男性,401 (36%)Latinx种族。截至2020年6月2日,127名(11%)患者死亡。总共有257(23%)的患者有神经诊断之前;最常见的是脑血管疾病(16%)。前脑血管疾病明显与重要疾病(或1.54(95%置信区间CI: 1.14 - 2.07)),低利率的成功拔管(特殊人力资源0.57(95%置信区间:0.33—-0.98)),并增加持续时间插管(限制意味着时差4.02天(95%置信区间:0.34—-10.92))相比没有脑血管疾病患者。
结论:脑血管疾病史的不利影响COVID-19结果包括重要疾病的风险增加和延长插管。还需要进一步的研究来确定措施,减少风险的可怜的结果在这个族群。
披露:Mukerji博士没有披露。立即家人Sudeshna Das已收到个人赔偿作为Alix Partners的一名雇员。立即Sudeshna Das的家人接到Alix Partners股票或所有权权益。Sudeshna Das的机构已经接受了NIA的研究支持。Sudeshna Das的机构收到质量生命科学研究支持中心。Sudeshna Das的机构已经接到IOS新闻研究支持。Alabsi博士没有披露。劳拉·布伦纳已经收到苹果的研究支持。Aayushee Jain没有披露。科林Magdamo已经收到了来自美国国立卫生研究院的研究支持。 Sarah Collens has nothing to disclose. Kiana Keller has nothing to disclose. Christine Boutros has nothing to disclose. Michael J. Leone has nothing to disclose. Elissa Ye has received personal compensation for serving as an employee of Massachusetts General Hospital. Dr. Newhouse has nothing to disclose. Brody Foy has nothing to disclose. Matthew Li has nothing to disclose. Mr. Lang has nothing to disclose. Melis Anahtar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Day Zero Diagnostics. Melis Anahtar has received stock or an ownership interest from Day Zero Diagnostics. An immediate family member of Melis Anahtar has received stock or an ownership interest from Day Zero Diagnostics. Yuping Shao has received personal compensation for serving as an employee of Mass General Hospital. Wendong Ge has nothing to disclose. Dr. Sun has nothing to disclose. Virginia Triant has nothing to disclose. Jayashree Kalpathy-Cramer, 13355 has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Radiological Society of North America. The institution of Jayashree Kalpathy-Cramer, 13355 has received research support from GE. The institution of Jayashree Kalpathy-Cramer, 13355 has received research support from Genentech Foundation. John Higgins has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sebia. John Higgins has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Danaher Diagnostics. The institution of John Higgins has received research support from NIH. The institution of John Higgins has received research support from Bioverativ. The institution of John Higgins has received research support from Partnership for Clean Competition. The institution of John Higgins has received research support from One Brave Idea Initiative. The institution of John Higgins has received research support from George Mason University. The institution of John Higgins has received research support from US Defense Advanced Research Projects Agency. John Higgins has received intellectual property interests from a discovery or technology relating to health care. Dr. Rosand has received personal compensation for serving as an employee of Massachusetts General Hospital. Dr. Rosand has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Boehringer Ingelheim. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Rosand has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Boehringer Ingelheim. The institution of Dr. Rosand has received research support from NIH. The institution of Dr. Rosand has received research support from OneMind. The institution of Dr. Rosand has received research support from American Heart Association. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as a Peer reviewer with National Institutes of Health. Dr. Rosand has a non-compensated relationship as a Board Member with Columbia University that is relevant to AAN interests or activities. The institution of Gregory Robbins has received research support from Gilead Sciences. The institution of Gregory Robbins has received research support from Citius Pharm. The institution of Gregory Robbins has received research support from Emergent Biosolutions. The institution of Gregory Robbins has received research support from Pfizer. The institution of Gregory Robbins has received research support from Leonard Meron Biosciences. The institution of Dr. Westover has received research support from NIH. Dr. Westover has received publishing royalties from a publication relating to health care. Dr. Westover has a non-compensated relationship as a cofounder with Beacon Biosignals that is relevant to AAN interests or activities.
