Postgraduation Program in Clinical Care in Nursing and Health, Ceará State University, Fortaleza, Ceará, Brazil.
Epidemiol Infect. 2020 Jun 25;148:e123. doi: 10.1017/S0950268820001405.
This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.
本研究旨在确定与巴西东北部 COVID-19 病例死亡率和存活率相关的风险因素。这是一项历史队列研究，使用了 2070 名出现流感样症状、在该州寻求医疗救助并经检测 COVID-19 呈阳性的人的二级数据库，直至 2020 年 4 月 14 日，仅中度和重度病例住院。主要结局是死亡，为二分类变量（是/否）。还调查了与疾病死亡率和存活率相关的主要因素。从症状开始到死亡/调查结束（2020 年 4 月 14 日）的时间是本研究的时间变量。死亡率采用稳健泊松回归分析，存活率采用 Kaplan-Meier 和 Cox 回归分析。在 2070 名 COVID-19 检测呈阳性的人中，有 131 人（6.3%）死亡，1939 人（93.7%）存活，感染第 24 天的总体存活率为 87.7%。死亡率增加的变量有：老年人（HR 3.6；95%CI 2.3-5.8；P < 0.001）、神经系统疾病（HR 3.9；95%CI 1.9-7.8；P < 0.001）、肺炎（HR 2.6；95%CI 1.4-4.7；P < 0.001）和心血管疾病（HR 8.9；95%CI 5.4-14.5；P < 0.001）。总之，塞阿拉州的 COVID-19 死亡率与有大量病例的国家相似，尽管死亡发生较晚。老年人和合并症的死亡风险更大。
