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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

使任何年纪的成年人因COVID-19病毒而病重风险增加的基础疾病列表的更新基于2019年12月1日至2020年10月16日期间发表的报告、媒体文章、未经审议的预印稿以及内部可用数据*。本列表是由CDC定期更新的动态文件,并且可能随着科学的发展而快速变化。COVID-19重病被定义为住院治疗、进入ICU、插管或机械通气,或者死亡。

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。

如果存在强有力的证据支持疾病的扩增,则此前列入的疾病合格条件将相应增加或移除。如果存在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。根据这一标准,在2020年3月的基础疾病列表中没有疾病被移除;但是,在2020年11月最近更新中,怀孕从“混合证据”上升为“有力证据”。

**吸烟的更新基于2019年12月1日至2020年7月20日之间的可用证据。

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
最有力且最一致的证据 癌症 系统综述 [6]
定群研究 [7, 8]
病例系列研究 [9]
慢性肾病 病例系列研究 [10, 1112]
定群研究 [13, 14, 15]
慢性阻塞性肺病(COPD) 元分析 [416]
病例系列研究 [17]
定群研究 [14]
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]
肥胖 (BMI> 30 kg/m2 定群研究 [18, 19, 20, 21, 22]
横向研究 [23]
严重肥胖(BMI> 40 kg/m2 定群研究 [98, 99]
横向研究 [95]
元分析 [107]
怀孕 系统综述[54, 116]
病例控制研究 [55]
病例系列研究 [5657, 5859]
定群研究 [60, 61, 62, 117]
镰状细胞病 病例系列研究 [24, 25, 26, 27, 28]
吸烟 元分析 [3, 16*, 63, 64, 65, 66, 101, 102, 104, 105]
实体器官移植 病例系列研究 [12, 29, 30, 31, 32, 33, 34]
元分析 [100]
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]
横向研究 [114]
混合证据 哮喘 定群研究 [14, 39, 40, 41]
病例系列研究 [17]
脑血管疾病 元分析 [42, 43, 44, 45]
证据综合 [46]
定群研究 [1, 2, 474849]
高血压 定群研究 [1, 2, 49, 50, 51, 91, 93]
病例系列研究 [92]
系统综述 [52]
元分析 [3, 4, 53, 94]
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]
有限证据 骨髓移植 综述 [72]
HIV 病例系列研究 [73, 74]
定群研究 [109, 110, 111, 112]
免疫缺陷 病例系列研究 [75]
系统综述 [76]
遗传性代谢紊乱 定群研究 [47, 77]
肝病 元分析 [78]
定群 研究 [79, 80, 118, 119]
文献综述 [81]
病例控制研究 [120]
神经系统疾病 横向研究 [82]
定群研究 [41, 49, 77]
其他慢性肺病 元分析 [4]
病例系列研究 [17]
定群研究 [14, 83]
超重(BMI > 25 kg/m2,但 < 30 kg/m2 定群研究 [96, 106]
病例系列研究 [97]
元分析 [115]
儿科学 系统综述[84, 85]
横向研究[82, 86, 107]
定群研究 [77, 87, 88, 103, 108, 113,121, 122, 125]
病例系列研究 [123, 124]
地中海贫血 病例系列研究 [89]
横向研究 [90]
1型糖尿病 病例系列研究 [11]
定群研究 [36, 37]
元分析 [38]
横向研究 [114]

**其他作者发现的方法论问题;由Guo[64] 重新分析,找到关联,发现严重性更高的危险因素。

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