학술논문
Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry
Document Type
article
Author
Milena S. Marcolino; Patricia K. Ziegelmann; Maira V.R. Souza-Silva; I.J.B. Nascimento; Luana M. Oliveira; Luanna S. Monteiro; Thaís L.S. Sales; Karen B. Ruschel; Karina P.M.P. Martins; Ana Paula B.S. Etges; Israel Molina; Carisi A. Polanczyk; Alexandre Vargas Schwarzbold; Amanda de Oliveira Maurílio; Ana Lara Rodrigues Monteiro de Barros; Ana Luiza Bahia Alves Scotton; Alfonso J. Rodríguez-Morales; Anderson Lacerda dos Reis; André Soares Moura Costa; Argenil José Assis de Oliveira; Bárbara Lopes Farace; Carla Thais Cândida Alves da Silva; Carolina Marques Ramos; Christiane Corrêa Rodrigues Cimini; Cíntia Alcantara de Carvalho; Daniel Vitório Silveira; Daniela Ponce; Emanuele Marianne Souza Kroger; Euler Roberto Fernandes Manenti; Fernanda Barbosa Lucas; Fernanda d'Athayde Rodrigues; Fernando Anschau; Fernando Antonio Botoni; Frederico Bartolazzi; Gabriela Petry Crestani; Guilherme Fagundes Nascimento; Helena Carolina Noal; Helena Duani; Heloisa Reniers Vianna; Henrique Cerqueira Guimarães; Joice Coutinho de Alvarenga; Júlia Drumond Parreiras de Morais; Juliana Machado Rugolo; Lara Monalyza Gonçalves Franco; Leila Beltrami Moreira; Leonardo Seixas de Oliveira; Lílian Santos Pinheiro; Liliane Souto Pacheco; Luciane Kopittke; Luciano de Souza Viana; Luis Cesar Souto de Moura; Luisa Elem Almeida Santos; Máderson Alvares de Souza Cabral; Maíra Dias Souza; Marcela Gonçalves Trindade Tofani; Marconi Franco da Silveira; Marcus Vinicius de Melo Andrade; Maria Angélica Pires Ferreira; Maria Aparecida Camargos Bicalho; Maria Auxiliadora Parreiras Martins; Maria Clara Pontello Barbosa Lima; Mariana Balbinot Borges; Mariana de Braga Lima Carvalho Canesso; Matheus Carvalho Alves Nogueira; Meire Pereira de Figueiredo; Milton Henriques Guimarães Junior; Mychelle Stefany Santos Almeida; Mônica Aparecida de Paula de Sordi; Natália da Cunha Severino Sampaio; Neimy Ramos de Oliveira; Paulo Tarso Lima Vianna; Pedro Guido Soares Andrade; Pedro Ledic Assaf; Rafael Fusaro Aguiar Oliveira; Rafael Lima Rodrigues de Carvalho; Rafaela dos Santos Charão de Almeida; Raphael Castro Martins; Reginaldo Aparecido Valacio; Ricardo Bertoglio Cardoso; Ricardo Braga Coelho; Roberta Pozza; Rodolfo Lucas Silva Mourato; Rodrigo Costa Pereira Vieira; Roger Mendes de Abreu; Rufino de Freitas Silva; Saionara Cristina Francisco; Silvana Mangeon Mereilles Guimarães; Silvia Ferreira Araújo; Talita Fischer Oliveira; Tatiana de Vargas; Tatiani Oliveira Fereguetti; Thalita Martins Lage; Thulio Henrique Oliveira Diniz; Veridiana Baldon dos Santos
Source
International Journal of Infectious Diseases, Vol 107, Iss , Pp 300-310 (2021)
Subject
Language
English
ISSN
1201-9712
Abstract
Objectives: To describe the clinical characteristics, laboratory results, imaging findings, and in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals. Methods: A cohort study of laboratory-confirmed COVID-19 patients who were hospitalized from March 2020 to September 2020 in 25 hospitals. Data were collected from medical records using Research Electronic Data Capture (REDCap) tools. A multivariate Poisson regression model was used to assess the risk factors for in-hospital mortality. Results: For a total of 2,054 patients (52.6% male; median age of 58 years), the in-hospital mortality was 22.0%; this rose to 47.6% for those treated in the intensive care unit (ICU). Hypertension (52.9%), diabetes (29.2%), and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation, and 12.1% required kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1%, and acute heart failure in 3.6%. Age >= 65 years, chronic kidney disease, hypertension, C-reactive protein ≥ 100 mg/dL, platelet count < 100 × 109/L, oxygen saturation < 90%, the need for supplemental oxygen, and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%. Conclusions: This study reveals the characteristics and in-hospital outcomes of hospitalized patients with confirmed COVID-19 in Brazil. Certain easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.