Grupo Hospitalar Conceição, Hospital Nossa Senhora da Conceição, Unidade de Terapia Intensiva Adulto, Porto Alegre, Rio Grande do Sul, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
Rev Inst Med Trop Sao Paulo. 2022 Feb 25;64:e20. doi: 10.1590/S1678-9946202264020. eCollection 2022.
COVID-19 is a disease whose knowledge is still under construction, high transmissibility, with no consensual treatment available to everyone. Therefore, the identification of patients at higher risk of evolving to the critical form of the disease is fundamental. The study aimed to determine risk factors associated with the severity of COVID-19 in adults patients. This is an observational, retrospective study from a cohort of adult patients with COVID-19 admitted to a public hospital from March to August 2020, whose medical records were evaluated. For the association of possible severity predictors, a Poisson regression was used. The primary outcome was the critical form of the disease (need for admission to the Intensive Care Unit and/or invasive mechanical ventilation). We included 565 patients: mostly men; 55.5% of those who progressed to the critical form of the disease were over sixty years old. Hypertension, diabetes mellitus and obesity were the most frequent comorbidities. There were 39.8% of patients who progressed to the critical form of the disease. The hospital mortality rate was 22.1%, and that of critical patients was 46.7%. The independent factors associated with the severity of the disease were obesity [RR = 1.33 (95% CI 1.07 to 1.66; p = 0.011)], SpO2/FiO2 ratio ≤ 315 [RR = 2.20 (95% CI 1.79 to 2.71; p = 0.000)], C-reactive protein > 100 mg/L [RR = 1.65 (95% CI 1.33 to 2.06; p = 0.000)], and lymphocytes < 1,000/µL [RR = 1.44 (95% CI 1.18 to 1.75; p = 0.000)]. Advanced age and comorbidities were dependent factors strongly associated with the critical form of the disease.
新型冠状病毒肺炎（COVID-19）是一种知识仍在不断完善的疾病，具有高度传染性，目前尚无针对所有人的共识性治疗方法。因此，确定哪些患者有更高的风险发展为疾病的危急形式至关重要。本研究旨在确定与成人 COVID-19 患者病情严重程度相关的危险因素。这是一项针对 2020 年 3 月至 8 月间在一家公立医院住院的成年 COVID-19 患者队列的观察性、回顾性研究，对其病历进行了评估。为了对可能的严重程度预测因素进行关联分析，我们使用了泊松回归。主要结局是疾病的危急形式（需要入住重症监护病房和/或接受有创机械通气）。我们共纳入 565 例患者：大多数为男性；55.5%发展为危急形式的患者年龄超过 60 岁。高血压、糖尿病和肥胖是最常见的合并症。有 39.8%的患者发展为危急形式。医院死亡率为 22.1%，危急患者的死亡率为 46.7%。与疾病严重程度相关的独立因素包括肥胖[RR=1.33（95%CI 1.07 至 1.66；p=0.011)]、SpO2/FiO2 比值≤315[RR=2.20（95%CI 1.79 至 2.71；p=0.000)]、C 反应蛋白>100mg/L[RR=1.65（95%CI 1.33 至 2.06；p=0.000)]和淋巴细胞<1,000/µL[RR=1.44（95%CI 1.18 至 1.75；p=0.000)]。高龄和合并症是与疾病危急形式密切相关的依赖因素。
