Baseline factors associated with death in a COVID-19 hospital cohort, Sao Paulo, 2020.

This study aimed to verify socio-demographic and baseline clinical factors associated with death in a hospital cohort of patients with COVID-19. A retrospective cohort study was conducted between February and December 2020 in a university hospital in the city of São Paulo, using Hospital Epidemiology Center data. RT-PCR-positive patients were selected to compose the sample (n = 1,034). At the end of the study, 362 (32%) patients died. In this cohort, age equal to or greater than sixty years (HR = 1.49) and liver disease (HR = 1.81) were independent risk factors for death from COVID-19 associated with higher in-hospital mortality.

Impact of In-Hospital infection with SARS-CoV-2 among Inpatients at a university hospital.

OBJECTIVE: The objective of this study was to evaluate the incidence of nosocomial infection and the impact of cross-transmission of SARS-CoV-2 among inpatients at a tertiary care teaching hospital. METHODS: This was a retrospective cohort study involving inpatients admitted to a tertiary university hospital in the city of São Paulo, Brazil, between March 2020 and February 2021. Cases were identified on the basis of a positive reverse-transcription polymerase chain reaction result for SARS-CoV-2 and the review of electronic medical records. Nosocomial transmission was defined by applying the criteria established by the Brazilian National Health Regulatory Agency. RESULTS: We identified 2146 cases of SARS-CoV-2 infection, 185 (8.6%) of which were considered cases of nosocomial transmission. The mean age was 58.3 years. The incidence density was 1.78 cases per 1,000 patient-days on the general wards, being highest on the cardiac surgery ward, and only 0.16 per 1,000 patient-days on the COVID-19 wards. Of the 185 patients evaluated, 115 (62.2%) were men, 150 (81.1%) cases had at least one comorbidity, and 104 (56.2%) evolved to death. CONCLUSIONS: Despite the preventive measures taken, nosocomial transmission of SARS-CoV-2 occurred throughout our hospital. Such measures should be intensified when the incidence of community transmission peaks.

Baseline factors associated with death in a COVID-19 hospital cohort, Sao Paulo, 2020

ABSTRACT This study aimed to verify socio-demographic and baseline clinical factors associated with death in a hospital cohort of patients with COVID-19. A retrospective cohort study was conducted between February and December 2020 in a university hospital in the city of São Paulo, using Hospital Epidemiology Center data. RT-PCR-positive patients were selected to compose the sample (n = 1,034). At the end of the study, 362 (32%) patients died. In this cohort, age equal to or greater than sixty years (HR = 1.49) and liver disease (HR = 1.81) were independent risk factors for death from COVID-19 associated with higher in-hospital mortality.

Implantação e avaliação de um modelo de gestão em Unidades Básicas de Saúde / Implementation and evaluation of a management model in Primary Care Settings

Objetivos: Verificar se o modelo de gestão do PNGS (Prêmio Nacional de Gestão em Saúde) pode ser entendido e utilizado para estimular melhoria de desempenho em Unidades Básicas de Saúde (UBS), bem como verificar se há diferença na gestão de UBS tradicionais e Unidades Saúde da Família (USF). Métodos: Este estudo foi realizado em 10 de 14 UBS de uma Supervisão Técnica de Saúde, município de São Paulo, no período de Agosto/2006 a Maio/2007. Após instrução, os gerentes elaboraram documento com o Perfil das UBS (Apresentação e Conteúdo) e Relatório de Gestão (RG). Como indicador de progresso na gestão foram realizados dois mutirões com 192 pacientes hipertensos das UBS, para verificar se houve melhora no controle da hipertensão. Resultados: O valor atribuído para o Perfil, item Apresentação, foi de 70,6 por cento e para Conteúdo 64,4 por cento. Na avaliação do RG, a soma total obtida pelas UBS variou de 16 (6,4 por cento) a 103 (41,2 por cento), de 250 pontos. As USF obtiveram médias superiores às obtidas pelas UBS tradicionais na Apresentação, Conteúdo e elaboração do RG (31,2 por cento e 20,4 por cento, respectivamente). Observou-se redução significante das pressões arteriais. Conclusões: O modelo do PNGS foi entendido e mostrou-se uma ferramenta útil para melhorar o desempenho nas UBS.