Amado Luciane Almeida, Coelho Wagner Luis da Costa Nunes Pimentel, Alves Arthur Daniel Rocha, Carneiro Vanessa Cristine de Souza, Moreira Otacilio da Cruz, de Paula Vanessa Salete, Lemos Andreza Salvio, Duarte Larissa Araujo, Gutman Elisa Gouvea, Fontes-Dantas Fabricia Lima, Gonçalves João Paulo da Costa, Ramos Carlos Henrique Ferreira, Ramos Filho Carlos Henrique Ferreira, Cavalcanti Marta Guimarães, Amaro Marisa Pimentel, Kader Rafael Lopes, Medronho Roberto de Andrade, Sarmento Dmitry José de Santana, Alves-Leon Soniza Vieira
Laboratory of Technological Development in Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro 21040-900, Brazil.
Laboratory of Molecular Virology, Oswaldo Cruz Institute/Fiocruz, Rio de Janeiro 21040-900, Brazil.
J Clin Med. 2023 Mar 29;12(7):2568. doi: 10.3390/jcm12072568.
Since COVID-19 was declared a pandemic, Brazil has become one of the countries most affected by this disease. A year into the pandemic, a second wave of COVID-19 emerged, with a rapid spread of a new SARS-CoV-2 lineage of concern. Several vaccines have been granted emergency-use authorization, leading to a decrease in mortality and severe cases in many countries. However, the emergence of SARS-CoV-2 variants raises the alert for potential new waves of transmission and an increase in pathogenicity. We compared the demographic and clinical data of critically ill patients infected with COVID-19 hospitalized in Rio de Janeiro during the first and second waves between July 2020 and October 2021. In total, 106 participants were included in this study; among them, 88% had at least one comorbidity, and 37% developed severe disease. Disease severity was associated with older age, pre-existing neurological comorbidities, higher viral load, and dyspnea. Laboratory biomarkers related to white blood cells, coagulation, cellular injury, inflammation, renal, and liver injuries were significantly associated with severe COVID-19. During the second wave of the pandemic, the necessity of invasive respiratory support was higher, and more individuals with COVID-19 developed acute hepatitis, suggesting that the progression of the second wave resulted in an increase in severe cases. These results can contribute to understanding the behavior of the COVID-19 pandemic in Brazil and may be helpful in predicting disease severity, which is a pivotal for guiding clinical care, improving patient outcomes, and defining public policies.
自新冠疫情被宣布为大流行以来，巴西已成为受该疾病影响最严重的国家之一。在疫情爆发一年后，第二波新冠疫情出现，一种新的值得关注的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）谱系迅速传播。几种疫苗已获得紧急使用授权，导致许多国家的死亡率和重症病例有所下降。然而，SARS-CoV-2变体的出现为潜在的新一轮传播和致病性增加敲响了警钟。我们比较了2020年7月至2021年10月期间在里约热内卢住院的新冠重症患者在第一波和第二波疫情期间的人口统计学和临床数据。本研究共纳入106名参与者；其中，88%至少有一种合并症，37%发展为重症疾病。疾病严重程度与年龄较大、既往存在神经合并症、病毒载量较高和呼吸困难有关。与白细胞、凝血、细胞损伤、炎症、肾脏和肝脏损伤相关的实验室生物标志物与重症新冠密切相关。在第二波疫情期间，有创呼吸支持的必要性更高，更多新冠患者出现急性肝炎，这表明第二波疫情的进展导致重症病例增加。这些结果有助于了解巴西新冠疫情的情况，并可能有助于预测疾病严重程度，这对于指导临床护理、改善患者预后和制定公共政策至关重要。
