Cohort study of hospitalized patients with COVID-19 at Brazilian tertiary-care hospital: Occurrence of adverse events and mortality

Author(s)

Luz, Maite Vasconcelos ; Silva, Julian Furtado ; Ceccato, Hugo Dugolin ; de Souza Junior, Paulo Jose ; Villar, Pedro Maximink ; Mendes, Paulo Roberto Araujo ; Resende, Mariangela Ribeiro ; Pereira, Monica Corso ; Conterno, Lucieni Oliveira

• Document type: Journal article
• Source: Brazilian Journal of Infectious Diseases; v. 27, n. 4, p. 8-pg., 2023-07-01.

Abstract

Introduction: Patients hospitalized with COVID-19 are often submitted to invasive proce-dures and they are at risk for hospital-associated adverse events. Objectives: To evaluate the epidemiological and clinical aspects of patients hospitalized with COVID-19; the occurrence of adverse events and the risk factors for mortality. Method: Cohort study that included adult patients hospitalized with a diagnosis of SAR-SCoV-2 infection, at the tertiary University Hospital of UNICAMP from March 2020 to March 2021. Patients were identified through the hospital epidemiological surveillance system and followed until discharge or death. Descriptive, comparative, and logistic regression analysis was performed. Results: 650 adult patients were included. The main adverse events identified were nosoco-mial infections (31.5%), renal failure (33.8%), thromboembolic and vascular events (12.6%). Mortality was higher among those with bloodstream infections (30.2% vs. 8.6%; p < 0.0001), ventilator-associated pneumonia (VAP, 52.5% vs. 12.3%; p < 0.0001), catheter associated uri-nary infection (27.3% vs. 7.2%; p < 0.0001); thromboembolic and vascular events (23.0% vs. 9.9%; p < 0.0001) and renal failure (81.3% vs. 20.9%; p < 0.0001). Klebsiella pneumoniae (15.6%), Pseudomonas aeruginosa (14.4%), Enterococcus faecalis (8.6%) were the most isolated bacteria. Logistic regression analysis identified age, (RR = 1.03; 95% CI 1.02 to 1.05); ICU admission (RR = 3.06; 95% CI 1.59 to 5.87), vasoactive drug use (RR = 3.1; 95% CI 1.79 to 4.82); renal fail-ure (RR = 7.76; 95% CI 4.54 to 13.26); and VAP (RR = 2.2; 95% CI 1.23 to 3.96), independently associated with mortality.Conclusion: adverse events have an important impact on the evolution of patients with COVID-19, reinforcing the need for optimized prevention and control measures as an essential part of care for these patients.& COPY; 2023 Sociedade Brasileira de Infectologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) (AU)

• FAPESP's process: 20/10439-3 - Epidemiological and clinical-evolutionary aspects of a cohort of patients hospitalized with COVID-19 at HC-Unicamp: occurrence of adverse events and factors related to the prognosis
• Grantee: Maitê Vasconcelos Luz
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 20/10087-0 - Prospective study of a cohort of patients discharged after severe acute respiratory syndrome and COVID-19: epidemiological, clinical and functional aspects
• Grantee: Mônica Corso Pereira
• Support Opportunities: Regular Research Grants