Marcolino Milena S, Ziegelmann Patricia K, Souza-Silva Maira V R, Nascimento I J B, Oliveira Luana M, Monteiro Luanna S, Sales Thaís L S, Ruschel Karen B, Martins Karina P M P, Etges Ana Paula B S, Molina Israel, Polanczyk Carisi A
Medical School and University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190 sala 246, Belo Horizonte, Brazil.
Universidade Federal do Rio Grande do Sul and Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359. Prédio 21, Sala 507, Porto Alegre, Brazil.
Int J Infect Dis. 2021 Jun;107:300-310. doi: 10.1016/j.ijid.2021.01.019. Epub 2021 Jan 12.
To describe the clinical characteristics, laboratory results, imaging findings, and in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals.
A cohort study of laboratory-confirmed COVID-19 patients who were hospitalized from March 2020 to September 2020 in 25 hospitals. Data were collected from medical records using Research Electronic Data Capture (REDCap) tools. A multivariate Poisson regression model was used to assess the risk factors for in-hospital mortality.
For a total of 2,054 patients (52.6% male; median age of 58 years), the in-hospital mortality was 22.0%; this rose to 47.6% for those treated in the intensive care unit (ICU). Hypertension (52.9%), diabetes (29.2%), and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation, and 12.1% required kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1%, and acute heart failure in 3.6%. Age >= 65 years, chronic kidney disease, hypertension, C-reactive protein ≥ 100mg/dL, platelet count < 100×10/L, oxygen saturation < 90%, the need for supplemental oxygen, and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%.
This study reveals the characteristics and in-hospital outcomes of hospitalized patients with confirmed COVID-19 in Brazil. Certain easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.
描述入住巴西医院的新冠肺炎患者的临床特征、实验室检查结果、影像学表现及院内结局。
对2020年3月至2020年9月期间在25家医院住院的实验室确诊的新冠肺炎患者进行队列研究。使用研究电子数据采集（REDCap）工具从病历中收集数据。采用多变量泊松回归模型评估院内死亡的危险因素。
共纳入2054例患者（男性占52.6%；中位年龄58岁），院内死亡率为22.0%；在重症监护病房（ICU）接受治疗的患者中，这一比例升至47.6%。高血压（52.9%）、糖尿病（29.2%）和肥胖（17.2%）是最常见的合并症。总体而言，32.5%的患者需要有创机械通气，12.1%的患者需要肾脏替代治疗。观察到15.0%的患者发生感染性休克，13.1%的患者发生医院感染，4.1%的患者发生血栓栓塞，3.6%的患者发生急性心力衰竭。年龄≥65岁、慢性肾脏病、高血压、C反应蛋白≥100mg/dL、血小板计数<100×10⁹/L、血氧饱和度<90%、入院时需要补充氧气以及需要有创机械通气与院内死亡风险较高独立相关。抗菌药物的总体使用率为87.9%。
本研究揭示了巴西确诊新冠肺炎住院患者的特征及院内结局。入院时某些易于评估的参数与较高的死亡风险独立相关。抗菌药物的高使用率表明新冠肺炎患者存在抗菌药物过度使用的情况。
