International Journal of Infectious Diseases (Jun 2021)

Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry

  • Milena S. Marcolino,
  • Patricia K. Ziegelmann,
  • Maira V.R. Souza-Silva,
  • I.J.B. Nascimento,
  • Luana M. Oliveira,
  • Luanna S. Monteiro,
  • Thaís L.S. Sales,
  • Karen B. Ruschel,
  • Karina P.M.P. Martins,
  • Ana Paula B.S. Etges,
  • Israel Molina,
  • Carisi A. Polanczyk,
  • Alexandre Vargas Schwarzbold,
  • Amanda de Oliveira Maurílio,
  • Ana Lara Rodrigues Monteiro de Barros,
  • Ana Luiza Bahia Alves Scotton,
  • Alfonso J. Rodríguez-Morales,
  • Anderson Lacerda dos Reis,
  • André Soares Moura Costa,
  • Argenil José Assis de Oliveira,
  • Bárbara Lopes Farace,
  • Carla Thais Cândida Alves da Silva,
  • Carolina Marques Ramos,
  • Christiane Corrêa Rodrigues Cimini,
  • Cíntia Alcantara de Carvalho,
  • Daniel Vitório Silveira,
  • Daniela Ponce,
  • Emanuele Marianne Souza Kroger,
  • Euler Roberto Fernandes Manenti,
  • Fernanda Barbosa Lucas,
  • Fernanda d'Athayde Rodrigues,
  • Fernando Anschau,
  • Fernando Antonio Botoni,
  • Frederico Bartolazzi,
  • Gabriela Petry Crestani,
  • Guilherme Fagundes Nascimento,
  • Helena Carolina Noal,
  • Helena Duani,
  • Heloisa Reniers Vianna,
  • Henrique Cerqueira Guimarães,
  • Joice Coutinho de Alvarenga,
  • Júlia Drumond Parreiras de Morais,
  • Juliana Machado Rugolo,
  • Lara Monalyza Gonçalves Franco,
  • Leila Beltrami Moreira,
  • Leonardo Seixas de Oliveira,
  • Lílian Santos Pinheiro,
  • Liliane Souto Pacheco,
  • Luciane Kopittke,
  • Luciano de Souza Viana,
  • Luis Cesar Souto de Moura,
  • Luisa Elem Almeida Santos,
  • Máderson Alvares de Souza Cabral,
  • Maíra Dias Souza,
  • Marcela Gonçalves Trindade Tofani,
  • Marconi Franco da Silveira,
  • Marcus Vinicius de Melo Andrade,
  • Maria Angélica Pires Ferreira,
  • Maria Aparecida Camargos Bicalho,
  • Maria Auxiliadora Parreiras Martins,
  • Maria Clara Pontello Barbosa Lima,
  • Mariana Balbinot Borges,
  • Mariana de Braga Lima Carvalho Canesso,
  • Matheus Carvalho Alves Nogueira,
  • Meire Pereira de Figueiredo,
  • Milton Henriques Guimarães Junior,
  • Mychelle Stefany Santos Almeida,
  • Mônica Aparecida de Paula de Sordi,
  • Natália da Cunha Severino Sampaio,
  • Neimy Ramos de Oliveira,
  • Paulo Tarso Lima Vianna,
  • Pedro Guido Soares Andrade,
  • Pedro Ledic Assaf,
  • Rafael Fusaro Aguiar Oliveira,
  • Rafael Lima Rodrigues de Carvalho,
  • Rafaela dos Santos Charão de Almeida,
  • Raphael Castro Martins,
  • Reginaldo Aparecido Valacio,
  • Ricardo Bertoglio Cardoso,
  • Ricardo Braga Coelho,
  • Roberta Pozza,
  • Rodolfo Lucas Silva Mourato,
  • Rodrigo Costa Pereira Vieira,
  • Roger Mendes de Abreu,
  • Rufino de Freitas Silva,
  • Saionara Cristina Francisco,
  • Silvana Mangeon Mereilles Guimarães,
  • Silvia Ferreira Araújo,
  • Talita Fischer Oliveira,
  • Tatiana de Vargas,
  • Tatiani Oliveira Fereguetti,
  • Thalita Martins Lage,
  • Thulio Henrique Oliveira Diniz,
  • Veridiana Baldon dos Santos

Journal volume & issue
Vol. 107
pp. 300 – 310

Abstract

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Objectives: To describe the clinical characteristics, laboratory results, imaging findings, and in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals. Methods: A cohort study of laboratory-confirmed COVID-19 patients who were hospitalized from March 2020 to September 2020 in 25 hospitals. Data were collected from medical records using Research Electronic Data Capture (REDCap) tools. A multivariate Poisson regression model was used to assess the risk factors for in-hospital mortality. Results: For a total of 2,054 patients (52.6% male; median age of 58 years), the in-hospital mortality was 22.0%; this rose to 47.6% for those treated in the intensive care unit (ICU). Hypertension (52.9%), diabetes (29.2%), and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation, and 12.1% required kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1%, and acute heart failure in 3.6%. Age >= 65 years, chronic kidney disease, hypertension, C-reactive protein ≥ 100 mg/dL, platelet count < 100 × 109/L, oxygen saturation < 90%, the need for supplemental oxygen, and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%. Conclusions: This study reveals the characteristics and in-hospital outcomes of hospitalized patients with confirmed COVID-19 in Brazil. Certain easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.

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