Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study
ABSTRACT COVID-19 is a disease whose knowledge is still under construction, high transmissibility, with no consensual treatment available to everyone. Therefore, the identification of patients at higher risk of evolving to the critical form of the disease is fundamental. The study aimed to determine...
Published in: | Revista do Instituto de Medicina Tropical de São Paulo |
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Online Access: | https://doi.org/10.1590/s1678-9946202264020 https://doaj.org/article/771bd8d786c242adbd4992f78c111654 |
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ftdoajarticles:oai:doaj.org/article:771bd8d786c242adbd4992f78c111654 2024-09-09T19:27:18+00:00 Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study Veridiana Baldon dos Santos Airton Tetelbom Stein Sofia Louise Santin Barilli Andresa Fontoura Garbini Rafaela Charão de Almeida Daniela dos Reis Carazai Fernanda Costa dos Santos Raquel Lutkmeier Isadora Helena Greve André Klafke Ketlen Monteiro Mussart Estefania Inez Wittke 2022-02-01T00:00:00Z https://doi.org/10.1590/s1678-9946202264020 https://doaj.org/article/771bd8d786c242adbd4992f78c111654 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652022000100208&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202264020 https://doaj.org/article/771bd8d786c242adbd4992f78c111654 Revista do Instituto de Medicina Tropical de São Paulo, Vol 64 (2022) COVID-19 SARS-CoV-2 Risk factors Severity Cohort study Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1590/s1678-9946202264020 2024-08-05T17:49:30Z ABSTRACT COVID-19 is a disease whose knowledge is still under construction, high transmissibility, with no consensual treatment available to everyone. Therefore, the identification of patients at higher risk of evolving to the critical form of the disease is fundamental. The study aimed to determine risk factors associated with the severity of COVID-19 in adults patients. This is an observational, retrospective study from a cohort of adult patients with COVID-19 admitted to a public hospital from March to August 2020, whose medical records were evaluated. For the association of possible severity predictors, a Poisson regression was used. The primary outcome was the critical form of the disease (need for admission to the Intensive Care Unit and/or invasive mechanical ventilation). We included 565 patients: mostly men; 55.5% of those who progressed to the critical form of the disease were over sixty years old. Hypertension, diabetes mellitus and obesity were the most frequent comorbidities. There were 39.8% of patients who progressed to the critical form of the disease. The hospital mortality rate was 22.1%, and that of critical patients was 46.7%. The independent factors associated with the severity of the disease were obesity [RR = 1.33 (95% CI 1.07 to 1.66; p = 0.011)], SpO2/FiO2 ratio ≤ 315 [RR = 2.20 (95% CI 1.79 to 2.71; p = 0.000)], C-reactive protein > 100 mg/L [RR = 1.65 (95% CI 1.33 to 2.06; p = 0.000)], and lymphocytes < 1,000/µL [RR = 1.44 (95% CI 1.18 to 1.75; p = 0.000)]. Advanced age and comorbidities were dependent factors strongly associated with the critical form of the disease. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 64 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
COVID-19 SARS-CoV-2 Risk factors Severity Cohort study Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
COVID-19 SARS-CoV-2 Risk factors Severity Cohort study Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Veridiana Baldon dos Santos Airton Tetelbom Stein Sofia Louise Santin Barilli Andresa Fontoura Garbini Rafaela Charão de Almeida Daniela dos Reis Carazai Fernanda Costa dos Santos Raquel Lutkmeier Isadora Helena Greve André Klafke Ketlen Monteiro Mussart Estefania Inez Wittke Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
topic_facet |
COVID-19 SARS-CoV-2 Risk factors Severity Cohort study Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
ABSTRACT COVID-19 is a disease whose knowledge is still under construction, high transmissibility, with no consensual treatment available to everyone. Therefore, the identification of patients at higher risk of evolving to the critical form of the disease is fundamental. The study aimed to determine risk factors associated with the severity of COVID-19 in adults patients. This is an observational, retrospective study from a cohort of adult patients with COVID-19 admitted to a public hospital from March to August 2020, whose medical records were evaluated. For the association of possible severity predictors, a Poisson regression was used. The primary outcome was the critical form of the disease (need for admission to the Intensive Care Unit and/or invasive mechanical ventilation). We included 565 patients: mostly men; 55.5% of those who progressed to the critical form of the disease were over sixty years old. Hypertension, diabetes mellitus and obesity were the most frequent comorbidities. There were 39.8% of patients who progressed to the critical form of the disease. The hospital mortality rate was 22.1%, and that of critical patients was 46.7%. The independent factors associated with the severity of the disease were obesity [RR = 1.33 (95% CI 1.07 to 1.66; p = 0.011)], SpO2/FiO2 ratio ≤ 315 [RR = 2.20 (95% CI 1.79 to 2.71; p = 0.000)], C-reactive protein > 100 mg/L [RR = 1.65 (95% CI 1.33 to 2.06; p = 0.000)], and lymphocytes < 1,000/µL [RR = 1.44 (95% CI 1.18 to 1.75; p = 0.000)]. Advanced age and comorbidities were dependent factors strongly associated with the critical form of the disease. |
format |
Article in Journal/Newspaper |
author |
Veridiana Baldon dos Santos Airton Tetelbom Stein Sofia Louise Santin Barilli Andresa Fontoura Garbini Rafaela Charão de Almeida Daniela dos Reis Carazai Fernanda Costa dos Santos Raquel Lutkmeier Isadora Helena Greve André Klafke Ketlen Monteiro Mussart Estefania Inez Wittke |
author_facet |
Veridiana Baldon dos Santos Airton Tetelbom Stein Sofia Louise Santin Barilli Andresa Fontoura Garbini Rafaela Charão de Almeida Daniela dos Reis Carazai Fernanda Costa dos Santos Raquel Lutkmeier Isadora Helena Greve André Klafke Ketlen Monteiro Mussart Estefania Inez Wittke |
author_sort |
Veridiana Baldon dos Santos |
title |
Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
title_short |
Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
title_full |
Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
title_fullStr |
Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
title_full_unstemmed |
Adult patients admitted to a tertiary hospital for COVID-19 and risk factors associated with severity: a retrospective cohort study |
title_sort |
adult patients admitted to a tertiary hospital for covid-19 and risk factors associated with severity: a retrospective cohort study |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2022 |
url |
https://doi.org/10.1590/s1678-9946202264020 https://doaj.org/article/771bd8d786c242adbd4992f78c111654 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 64 (2022) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652022000100208&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202264020 https://doaj.org/article/771bd8d786c242adbd4992f78c111654 |
op_doi |
https://doi.org/10.1590/s1678-9946202264020 |
container_title |
Revista do Instituto de Medicina Tropical de São Paulo |
container_volume |
64 |
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1809896748924010496 |