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增加COVID-19重病风险的基础疾病列表更新所用的证据

增加COVID-19重病风险的基础疾病列表更新所用的证据

导致COVID-19重病风险增加的基础疾病列表的更新内容以2019年12月1日至2020年7月10日期间的已发布报告、待刊文章、未评审预印本以及可用的内部数据为依据。此列表是由CDC定期更新的动态文件,并且可能随着科学发展而快速变化。COVID-19重病的定义为住院治疗、进入重症监护室、插管或机械辅助呼吸,或死亡。

每种疾病的证据水平由CDC审核人员基于COVID-19相关可用信息确定。如果证据表明与COVID-19重病的相关性满足以下任何标准,则这些疾病会被加入列表中(如果不是已经存在于此前的基础疾病列表中[最初发布于2020年3月]):

  • 最有力且最一致的证据:定义为来自多个小型研究的一致性证据或来自一项大型研究的强有力的关联。
  • 混合证据:定义为多项研究得出关于某疾病相关风险的不同结论,或者
  • 有限证据:定义为来自少数研究的一致性证据。将某种疾病与COVID-19重病相关性进行分类,该疾病被加入列表(如果并非已经存在于此前的基础疾病列表中[最初发布于2020年3月])。

如果有强有力的证据支持扩展疾病,则此前列入的疾病合格条件将相应增加或移除。如果有强有力且一致的证据表明与严重后果没有相关性,则移除此前列入的疾病。基于此标准,2020年3月制定的基础疾病列表中还没有疾病被移除。

增加COVID-19重病风险的基础疾病列表更新所用的证据
证据水平 疾病 对COVID-19严重性的影响证据 备注
最有力且最一致的证据 严重心脏病,如心力衰竭、冠状动脉疾病或心肌病 定群研究 [1, 2]
元分析 [3, 4]
病例系列研究 [5]
此前的列表版本中表述为“严重心脏病”
癌症 系统综述 [6]
定群研究 [7, 8]
病例系列研究 [9]
2020年7月17日新增至更新列表
慢性肾病 病例系列研究 [10, 1112]
定群研究 [13, 14, 15]
此前列表版本中表述为“需要透析的慢性肾病”
慢性阻塞性肺病(COPD) 元分析 [416]
病例系列研究 [17]
定群研究 [14]
在此前列表版本中列明
肥胖 (BMI> 30) 定群研究 [18, 19, 20, 21, 22]
横向研究 [23]
此前列表版本中表述为“严重肥胖(BMI ≥40)”
镰状细胞病 病例系列研究 [24, 25, 26, 27, 28] 在此前列表版本中列明
实体器官移植 病例系列研究 [12, 29, 30, 31, 32,, 33, 34] 2020年6月25日更新列表新增
2型糖尿病 病例系列研究 [11]
纵向研究 [35]
定群研究 [36, 37]
元分析 [38]
在此前列表版本中列明
混合证据 哮喘 定群研究 [14, 39, 40, 41]
病例系列研究 [17]
在此前列表版本中列明
脑血管疾病 元分析 [42, 43, 44, 45]
证据综合 [46]
定群研究 [1, 2, 474849]
2020年6月25日更新列表新增
高血压 定群研究 [1, 2, 49, 50, 51]
系统综述 [52]
元分析 [3, 4, 53]
2020年6月25日更新列表新增
怀孕 系统综述 [54]
病例控制研究 [55]
病例系列研究 [5657, 5859]
定群研究 [60, 61, 62]
吸烟 元分析 [3, 63, 64, 65, 66] 在此前列表版本中列明
服用皮质类固醇或其他免疫抑制药物 病例系列研究 [67, 68, 69]
定群研究 [70, 71]
在此前列表版本中列明
有限证据 骨髓移植 综述 [72] 在此前列表版本中列明
HIV 病例系列研究 [73, 74] 在此前列表版本中列明
免疫缺陷 病例系列研究 [75]
系统综述 [76]
在此前列表版本中列明
遗传性代谢紊乱 定群研究 [47, 77] 2020年6月25日更新列表新增;当前只适用于儿科人群
肝病 元分析 [78]
定群研究 [79, 80]
文献综述 [81]
在此前列表版本中列明
神经系统疾病 横向研究 [82]
定群研究 [41, 49, 77]
2020年6月25日更新列表新增;当前只适用于儿科人群
其他慢性肺病 元分析 [4]
病例系列研究 [17]
定群研究 [14, 83]
在此前列表版本中列明
儿科学 系统综述[84, 85]
横向研究[82, 86]
定群研究 [77, 87, 88]
2020年7月17日新增至更新列表
地中海贫血 病例系列研究 [89]
横向研究 [90]
在此前列表版本中列明
1型糖尿病 病例系列研究 [11]
定群研究 [36, 37]
元分析 [38]
在此前列表版本中列明

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2020年7月28日最后更新