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

Autor(es)

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

• Tipo de documento: Artigo Científico
• Fonte: Brazilian Journal of Infectious Diseases; v. 27, n. 4, p. 8-pg., 2023-07-01.

Resumo

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)

• Processo FAPESP: 20/10439-3 - Aspectos epidemiológicos e clínico-evolutivos de uma coorte de pacientes internados com COVID-19 no HC-Unicamp: ocorrência de eventos adversos e fatores relacionados ao prognóstico
• Beneficiário: Maitê Vasconcelos Luz
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 20/10087-0 - Estudo prospectivo de uma coorte de pacientes egressos de internação por síndrome respiratória aguda grave e COVID-19: aspectos epidemiológicos, clínicos e funcionais
• Beneficiário: Mônica Corso Pereira
• Modalidade de apoio: Auxílio à Pesquisa - Regular