학술논문
Clinical characteristics and outcomes of patients with COVID-19 admitted to the intensive care unit during the first and second waves of the pandemic in Brazil: a single-center retrospective cohort study.
Document Type
Academic Journal
Author
Corrêa TD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Midega TD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Cordioli RL; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Barbas CSV; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Rabello Filho R; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Silva BCD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Silva Júnior M; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Nawa RK; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Carvalho FRT; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Matos GFJ; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Lucinio NM; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Rodrigues RD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Eid RAC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Bravim BA; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Pereira AJ; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Santos BFCD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Pinho JRR; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Pardini A; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Teich VD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Laselva CR; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Cendoroglo Neto M; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Klajner S; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.; Ferraz LJR; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Source
Publisher: Instituto de Ensino e Pesquisa Albert Einstein Country of Publication: Brazil NLM ID: 101281800 Publication Model: eCollection Cited Medium: Internet ISSN: 2317-6385 (Electronic) Linking ISSN: 16794508 NLM ISO Abbreviation: Einstein (Sao Paulo) Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To describe and compare the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic.
Methods: In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic.
Results: In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p<0.001], had a lower SAPS 3 Score [45 (42-52) versus 49 (43-57); p<0.001], lower SOFA Score on intensive care unit admission [3 (1-6) versus 4 (2-6); p=0.018], lower Charlson Comorbidity Index [0 (0-1) versus 1 (0-2); p<0.001], and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves.
Conclusion: In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission.
Methods: In this retrospective single-center cohort study, data were retrieved from the Epimed Monitor System; all adult patients admitted to the intensive care unit between March 4, 2020, and October 1, 2021, were included in the study. We compared the clinical characteristics and outcomes of patients admitted to the intensive care unit of a quaternary private hospital in São Paulo, Brazil, during the first (May 1, 2020, to August 31, 2020) and second (March 1, 2021, to June 30, 2021) waves of the COVID-19 pandemic.
Results: In total, 1,427 patients with COVID-19 were admitted to the intensive care unit during the first (421 patients) and second (1,006 patients) waves. Compared with the first wave group [median (IQR)], the second wave group was younger [57 (46-70) versus 67 (52-80) years; p<0.001], had a lower SAPS 3 Score [45 (42-52) versus 49 (43-57); p<0.001], lower SOFA Score on intensive care unit admission [3 (1-6) versus 4 (2-6); p=0.018], lower Charlson Comorbidity Index [0 (0-1) versus 1 (0-2); p<0.001], and were less frequently frail (10.4% versus 18.1%; p<0.001). The second wave group used more noninvasive ventilation (81.3% versus 53.4%; p<0.001) and high-flow nasal cannula (63.2% versus 23.0%; p<0.001) during their intensive care unit stay. The intensive care unit (11.3% versus 10.5%; p=0.696) and in-hospital mortality (12.3% versus 12.1%; p=0.998) rates did not differ between both waves.
Conclusion: In the first and second waves, patients with severe COVID-19 exhibited similar mortality rates and need for invasive organ support, despite the second wave group being younger and less severely ill at the time of intensive care unit admission.