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https://www.arca.fiocruz.br/handle/icict/61070
RELATIONSHIP BETWEEN CLINICAL-EPIDEMIOLOGICAL PARAMETERS AND OUTCOMES OF PATIENTS WITH COVID-19 ADMITTED TO THE INTENSIVE CARE UNIT: A REPORT FROM A BRAZILIAN HOSPITAL.
SARS-CoV-2
biomarkers
epidemiology
SAPS3
in-hospital mortality
intensive care unit
catheter
Author
Sodré, Maisah Meyhr D’Carmo
Santos, Uener Ribeiro dos
Povoas, Heitor Portella
Guzmán, Júlio Lenin
Giusta, Caroline Junqueira
Trindade, Tayana Oliveira
Gadelha, Sandra Rocha
Romano, Carla Cristina
Conceição, Aline Oliveira da
Gross, Eduardo
Silva, Aline
Rezende, Rachel Passos
Fontana, Renato
Mata, Camila Pacheco Silveira Martins da
Marin, Lauro Juliano
Carvalho, Luciana Debortoli de
Santos, Uener Ribeiro dos
Povoas, Heitor Portella
Guzmán, Júlio Lenin
Giusta, Caroline Junqueira
Trindade, Tayana Oliveira
Gadelha, Sandra Rocha
Romano, Carla Cristina
Conceição, Aline Oliveira da
Gross, Eduardo
Silva, Aline
Rezende, Rachel Passos
Fontana, Renato
Mata, Camila Pacheco Silveira Martins da
Marin, Lauro Juliano
Carvalho, Luciana Debortoli de
Affilliation
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Program in Cellular and Molecular Medicine. Boston Children's Hospital. Boston, MA, United States/Department of Pediatrics. Harvard Medical School. Boston, MA, United States/René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Laboratory of Microbiology. Risoleta Tolentino Neves Hospital. Belo Horizonte, MG, Brazil
Department of Health. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Program in Cellular and Molecular Medicine. Boston Children's Hospital. Boston, MA, United States/Department of Pediatrics. Harvard Medical School. Boston, MA, United States/René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil
Hospital de Ilhéus. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Laboratory of Microbiology. Risoleta Tolentino Neves Hospital. Belo Horizonte, MG, Brazil
Department of Health. Santa Cruz State University. Ilhéus, BA, Brazil
Department of Biological Sciences. Santa Cruz State University. Ilhéus, BA, Brazil
Abstract
Background: People in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.
Materials and methods: We conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.
Results: The use of bladder catheters (OR 79.30; p < 0.0001) and central venous catheters (OR, 45.12; p < 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p < 0.0001) and prolonged ICU stay (p < 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p < 0.0001).
Conclusion: We suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU.
Keywords
COVID-19SARS-CoV-2
biomarkers
epidemiology
SAPS3
in-hospital mortality
intensive care unit
catheter
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