Santos Ricardo S, Barros Danilo S, Moraes Thiago M P, Hayashi Cintya Y, Ralio Renata B, Minenelli Fernanda F, van Zon Kees, Ripardo João P S
Philips Research North America, Cambridge, MA, USA.
Hospital Samaritano Higienópolis - Americas Serviços Médicos, São Paulo, SP, Brazil.
IJID Reg. 2022 Jun;3:189-195. doi: 10.1016/j.ijregi.2022.04.002. Epub 2022 Apr 14.
To describe clinical characteristics, hospitalization flow and outcomes in a cohort of patients with coronavirus disease 2019 (COVID-19) in a Brazilian hospital in the first and second waves of the pandemic.
This retrospective, observational study included patients with confirmed COVID-19 who were evaluated in the emergency department (ED) between 1 March 2020 and 30 June 2021. Descriptive statistics have been used to report clinical characteristics, admissions and outcomes. Comparison between the two waves was inferred using hypothesis test techniques.
During the study period, 7723 (86.54%) patients were evaluated in the ED, of which 1908 (24.70%) were admitted. Of these, 476 (24.95%) patients were initially allocated to the intensive care unit (ICU) and 1432 (75.05%) to the general ward. Of the patients initially allocated to the general ward, 349 (24.37%) were later transferred to the ICU. One hundred and fifty-eight patients were intubated (19.15% of ICU admissions) and 110 patients died (5.77% of all admissions). In the second wave, the admission rates decreased in both the ICU (from 13.84% to 9.56%; <0.01) and the general ward (from 22.41% to 17.16%; <0.01). The average age in the second wave decreased from 44.06 to 41.87 years (<0.01). Patients with severe symptoms, such as dyspnoea, decreased from 25.51% to 13.13% (<0.01) in the second wave. The death rate among admitted patients decreased by 17.84% (from 6.52% to 5.38%; <0.01).
Despite the greater number of patients in the second wave, the admission and death rates were lower compared with the first wave. The mean age of patients was lower in the second wave, and patients arrived at the hospital with less severe symptoms compared with the first wave.
描述在巴西一家医院中，2019冠状病毒病（COVID-19）患者在疫情第一波和第二波期间的临床特征、住院流程及结局。
这项回顾性观察研究纳入了2020年3月1日至2021年6月30日期间在急诊科接受评估的确诊COVID-19患者。采用描述性统计报告临床特征、入院情况及结局。使用假设检验技术推断两波疫情之间的差异。
在研究期间，7723名（86.54%）患者在急诊科接受了评估，其中1908名（24.70%）入院。其中，476名（24.95%）患者最初被分配到重症监护病房（ICU），1432名（75.05%）被分配到普通病房。在最初被分配到普通病房的患者中，349名（24.37%）后来被转至ICU。158名患者接受了气管插管（占ICU入院患者的19.15%），110名患者死亡（占所有入院患者的5.77%）。在第二波疫情期间，ICU的入院率（从13.84%降至9.56%；<0.01）和普通病房的入院率（从22.41%降至17.16%；<0.01）均有所下降。第二波疫情期间患者的平均年龄从44.06岁降至41.87岁（<0.01）。第二波疫情期间出现严重症状（如呼吸困难）的患者比例从25.51%降至13.13%（<0.01）。入院患者的死亡率下降了17.84%（从6.52%降至5.38%；<0.01）。
尽管第二波疫情期间患者数量更多，但与第一波相比，入院率和死亡率更低。第二波疫情期间患者的平均年龄更低，且与第一波相比，患者入院时症状较轻。
