Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study

Author(s):Show less -

Brandao Neto, Rodrigo A. ^[1] ; Marchini, Julio F. ^[1] ; Marino, Lucas O. ^[1] ; Alencar, Julio C. G. ^[1] ; Lazar Neto, Felippe ^[1] ; Ribeiro, Sabrina ^[1] ; Salvetti, Fernando V. ^[1] ; Rahhal, Hassan ^[1] ; Gomez Gomez, Luz Marina ^[1] ; Bueno, Caue G. ^[1] ; Faria, Carine C. ^[1] ; da Cunha, Victor P. ^[1] ; Padrao, Eduardo ^[1] ; Velasco, Irineu T. ^[1] ; de Souza, Heraldo Possolo ^[2] ; Grp, Emergencia USP Covid

Affiliation

^[1] Univ Sao Paulo, Fac Med, Hosp Clin, Emergency Dept, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Med Sch, Sao Paulo - Brazil

• Document type: Journal article
• Source: PLoS One; v. 16, n. 1 JAN 7 2021.
• Web of Science Citations: 2

Abstract

Background The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients. Methods From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others. Results From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality Conclusions This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies. (AU)

• FAPESP's process: 19/23078-1 - Evaluation of elderly people at an emergency service
• Grantee: Luz Marina Gómez Gómez
• Support Opportunities: Scholarships in Brazil - Post-Doctoral