Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study
Abstract BACKGROUND: There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil. OBJECTIVE: To determine the mortality predictors in COVID-19 patients...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
2022-09-01
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005023208&tlng=en |
| _version_ | 1811209599317966848 |
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| author | Regina Maria Alexandre Fernandes de Oliveira Milton Luiz Gorzoni Ronaldo Fernandes Rosa |
| author_facet | Regina Maria Alexandre Fernandes de Oliveira Milton Luiz Gorzoni Ronaldo Fernandes Rosa |
| author_sort | Regina Maria Alexandre Fernandes de Oliveira |
| collection | DOAJ |
| description | Abstract BACKGROUND: There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil. OBJECTIVE: To determine the mortality predictors in COVID-19 patients admitted to a tertiary hospital in São Paulo, Brazil. DESIGN AND SETTING: A retrospective analysis of medical records of COVID-19 patients admitted to the Hospital Central da Irmandade da Santa Casa de Misericórdia of São Paulo. METHODS: Overall, 316 patients with laboratory-confirmed COVID-19 between March 1, 2020, and July 31, 2020, were included. The analysis included the baseline characteristics, clinical progression, and outcomes. RESULTS: The mortality rate of the sample was 51.27%. Age ≥ 60 years was determined as a risk factor after multivariate logistic regression analysis. Patients with an oxygen (O2) saturation ≤ 94% upon admission accounted for 87% of the deaths (P < 0.001). Vasoactive drugs were used in 92% (P < 0.001) of patients who progressed to death, and mechanical ventilation was employed in 88% (P < 0.001) of such patients. However, patients who received corticosteroids concomitantly with mechanical ventilation had a better prognosis than those who did not. The progressive degree of pulmonary involvement observed on chest computed tomography was correlated with a worse prognosis. The presence of thrombocytopenia has been considered as a risk factor for mortality. CONCLUSION: The main predictors of in-hospital mortality after logistic regression analysis were age, O2 saturation ≤ 94% upon admission, use of vasoactive drugs, and presence of thrombocytopenia. |
| first_indexed | 2024-04-12T04:42:22Z |
| format | Article |
| id | doaj.art-9ad73ef4c92a4f798261a9cf8294097d |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-04-12T04:42:22Z |
| publishDate | 2022-09-01 |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-9ad73ef4c92a4f798261a9cf8294097d2022-12-22T03:47:35ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602022-09-0110.1590/1516-3180.2021.0914.r2.13062022Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective studyRegina Maria Alexandre Fernandes de Oliveirahttps://orcid.org/0000-0003-0731-3408Milton Luiz Gorzonihttps://orcid.org/0000-0002-7627-3203Ronaldo Fernandes Rosahttps://orcid.org/0000-0001-8744-2861Abstract BACKGROUND: There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil. OBJECTIVE: To determine the mortality predictors in COVID-19 patients admitted to a tertiary hospital in São Paulo, Brazil. DESIGN AND SETTING: A retrospective analysis of medical records of COVID-19 patients admitted to the Hospital Central da Irmandade da Santa Casa de Misericórdia of São Paulo. METHODS: Overall, 316 patients with laboratory-confirmed COVID-19 between March 1, 2020, and July 31, 2020, were included. The analysis included the baseline characteristics, clinical progression, and outcomes. RESULTS: The mortality rate of the sample was 51.27%. Age ≥ 60 years was determined as a risk factor after multivariate logistic regression analysis. Patients with an oxygen (O2) saturation ≤ 94% upon admission accounted for 87% of the deaths (P < 0.001). Vasoactive drugs were used in 92% (P < 0.001) of patients who progressed to death, and mechanical ventilation was employed in 88% (P < 0.001) of such patients. However, patients who received corticosteroids concomitantly with mechanical ventilation had a better prognosis than those who did not. The progressive degree of pulmonary involvement observed on chest computed tomography was correlated with a worse prognosis. The presence of thrombocytopenia has been considered as a risk factor for mortality. CONCLUSION: The main predictors of in-hospital mortality after logistic regression analysis were age, O2 saturation ≤ 94% upon admission, use of vasoactive drugs, and presence of thrombocytopenia.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005023208&tlng=enSARS-CoV-2COVID-19MortalityHospitalizationPrognosisPredictorsOutcomeParameters |
| spellingShingle | Regina Maria Alexandre Fernandes de Oliveira Milton Luiz Gorzoni Ronaldo Fernandes Rosa Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study São Paulo Medical Journal SARS-CoV-2 COVID-19 Mortality Hospitalization Prognosis Predictors Outcome Parameters |
| title | Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study |
| title_full | Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study |
| title_fullStr | Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study |
| title_full_unstemmed | Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study |
| title_short | Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study |
| title_sort | mortality predictors in a cohort of patients with covid 19 admitted to a large tertiary hospital in the city of sao paulo brazil a retrospective study |
| topic | SARS-CoV-2 COVID-19 Mortality Hospitalization Prognosis Predictors Outcome Parameters |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802022005023208&tlng=en |
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