Department of Neurosurgery, Getúlio Vargas University Hospital, Manaus, Amazonas, Brazil.
Department of Cardiology, Memorial Hospital System, Hollywood, Florida, United States of America.
PLoS One. 2023 Feb 10;18(2):e0280891. doi: 10.1371/journal.pone.0280891. eCollection 2023.
COVID-19 is a contagious infection caused by the SARS-CoV-2 virus, responsible for more than 5 million deaths worldwide, and has been a significant challenge for healthcare systems worldwide. Characterized by multiple manifestations, the most common symptoms are fever, cough, anosmia, ageusia, and myalgia. However, several organs can be affected in more severe cases, causing encephalitis, myocarditis, respiratory distress, hypercoagulable state, pulmonary embolism, and stroke. Despite efforts to identify appropriate clinical protocols for its management, there are still no fully effective therapies to prevent patient death. The objective of this study was to describe the demographic, clinical, and pharmacotherapeutic management characteristics employed in patients hospitalized for diagnosis of COVID-19, in addition to identifying predictive factors for mortality. This is a single-center, retrospective cohort study carried out in a reference hospital belonging to the Brazilian public health system, in Manaus, from March 2020 to July 2021. Data were obtained from analyzing medical records, physical and electronic forms, medical prescriptions, and antimicrobial use authorization forms. During the study period, 530 patients were included, 51.70% male, with a mean age of 58.74 ± 15.91 years. The overall mortality rate was 23.58%. The variables age, number of comorbidities, admission to the ICU, length of stay, oxygen saturation, serum aspartate transaminase, and use of mechanical ventilation showed a positive correlation with the mortality rate. Regarding pharmacological management, 88.49% of patients used corticosteroids, 86.79% used antimicrobials, 94.15% used anticoagulant therapy, and 3.77% used immunotherapy. Interestingly, two specific classes of antibiotics showed a positive correlation with the mortality rate: penicillins and glycopeptides. After multivariate logistic regression analysis, age, number of comorbidities, need for mechanical ventilation, length of hospital stay, and penicillin or glycopeptide antibiotics use were associated with mortality (AUC = 0.958).
COVID-19 是一种由 SARS-CoV-2 病毒引起的传染性感染，已导致全球超过 500 万人死亡，对全球医疗系统构成重大挑战。其具有多种表现形式，最常见的症状是发热、咳嗽、嗅觉丧失、味觉丧失和肌肉疼痛。然而，在更严重的情况下，多个器官可能受到影响，导致脑炎、心肌炎、呼吸窘迫、高凝状态、肺栓塞和中风。尽管努力确定管理该病的适当临床方案，但仍没有完全有效的治疗方法来预防患者死亡。本研究的目的是描述因 COVID-19 住院的患者的人口统计学、临床和药物治疗管理特征，并确定死亡的预测因素。这是一项在 2020 年 3 月至 2021 年 7 月期间在巴西公立卫生系统所属的一家参考医院进行的单中心回顾性队列研究。数据来自分析病历、体格和电子表格、处方和抗菌药物使用授权表。在研究期间，共纳入 530 例患者，其中 51.70%为男性，平均年龄为 58.74 ± 15.91 岁。总死亡率为 23.58%。年龄、共病数量、入住 ICU、住院时间、血氧饱和度、血清天冬氨酸转氨酶和机械通气使用等变量与死亡率呈正相关。在药物治疗方面，88.49%的患者使用皮质类固醇，86.79%的患者使用抗生素，94.15%的患者使用抗凝治疗，3.77%的患者使用免疫疗法。有趣的是，两类特定的抗生素与死亡率呈正相关：青霉素类和糖肽类。多变量逻辑回归分析后，年龄、共病数量、需要机械通气、住院时间以及使用青霉素类或糖肽类抗生素与死亡率相关（AUC = 0.958）。
