Association of latitude and altitude with adverse outcomes in patients with COVID-19: The VIRUS registry.

Autor:	Tekin A; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States., Qamar S; Post-baccalaureate Research Education Program, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, United States., Singh R; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States., Bansal V; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Sharma M; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States., LeMahieu AM; Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States., Hanson AC; Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States., Schulte PJ; Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905, United States., Bogojevic M; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Deo N; Alix School of Medicine, Mayo Clinic, Rochester, MN 55905, United States., Zec S; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Valencia Morales DJ; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States., Belden KA; Division of Infectious Diseases, Thomas Jefferson University Hospital, Philadelphia, PA 19107, United States., Heavner SF; Prisma Health, Greenville, SC 29605, United States., Kaufman M; Englewood Health, Englewood, NJ 07631, United States., Cheruku S; Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX 75390, United States., Danesh VC; Center for Applied Health Research, Baylor Scott and White Health, Dallas, TX 75246, United States., Banner-Goodspeed VM; Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States., St Hill CA; Allina Health, Minneapolis, MN 55407, United States., Christie AB; Department of Critical Care, Atrium Health Navicent, Macon, GA 31201, United States., Khan SA; Division of Critical Care Medicine, Mayo Clinic Health System, Mankato, MN 56001, United States., Retford L; Society of Critical Care Medicine, Mount Prospect, IL 60056, United States., Boman K; Society of Critical Care Medicine, Mount Prospect, IL 60056, United States., Kumar VK; Society of Critical Care Medicine, Mount Prospect, IL 60056, United States., O'Horo JC; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Domecq JP; Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Walkey AJ; Pulmonary Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Evans Center of Implementation and Improvement Sciences, Boston University School of Medicine, Boston, MA 02118, United States., Gajic O; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States., Kashyap R; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States., Surani S; Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States.
Jazyk:	angličtina
Zdroj:	World journal of critical care medicine [World J Crit Care Med] 2022 Mar 09; Vol. 11 (2), pp. 102-111. Date of Electronic Publication: 2022 Mar 09 (Print Publication: 2022).
DOI:	10.5492/wjccm.v11.i2.102
Abstrakt:	Background: The coronavirus disease 2019 (COVID-19) course may be affected by environmental factors. Ecological studies previously suggested a link between climatological factors and COVID-19 fatality rates. However, individual-level impact of these factors has not been thoroughly evaluated yet. Aim: To study the association of climatological factors related to patient location with unfavorable outcomes in patients. Methods: In this observational analysis of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study: COVID-19 Registry cohort, the latitudes and altitudes of hospitals were examined as a covariate for mortality within 28 d of admission and the length of hospital stay. Adjusting for baseline parameters and admission date, multivariable regression modeling was utilized. Generalized estimating equations were used to fit the models. Results: Twenty-two thousand one hundred eight patients from over 20 countries were evaluated. The median age was 62 (interquartile range: 49-74) years, and 54% of the included patients were males. The median age increased with increasing latitude as well as the frequency of comorbidities. Contrarily, the percentage of comorbidities was lower in elevated altitudes. Mortality within 28 d of hospital admission was found to be 25%. The median hospital-free days among all included patients was 20 d. Despite the significant linear relationship between mortality and hospital-free days (adjusted odds ratio (aOR) = 1.39 (1.04, 1.86), P = 0.025 for mortality within 28 d of admission; aOR = -1.47 (-2.60, -0.33), P = 0.011 for hospital-free days), suggesting that adverse patient outcomes were more common in locations further away from the Equator; the results were no longer significant when adjusted for baseline differences (aOR = 1.32 (1.00, 1.74), P = 0.051 for 28-day mortality; aOR = -1.07 (-2.13, -0.01), P = 0.050 for hospital-free days). When we looked at the altitude's effect, we discovered that it demonstrated a non-linear association with mortality within 28 d of hospital admission (aOR = 0.96 (0.62, 1.47), 1.04 (0.92, 1.19), 0.49 (0.22, 0.90), and 0.51 (0.27, 0.98), for the altitude points of 75 MASL, 125 MASL, 400 MASL, and 600 MASL, in comparison to the reference altitude of 148 m.a.s.l, respectively. P = 0.001). We detected an association between latitude and 28-day mortality as well as hospital-free days in this worldwide study. When the baseline features were taken into account, however, this did not stay significant. Conclusion: Our findings suggest that differences observed in previous epidemiological studies may be due to ecological fallacy rather than implying a causal relationship at the patient level. Competing Interests: Conflict-of-interest statement: None of the authors have any conflict of interest to disclose. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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