Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital.

Background: People in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death. Materials and methods: We conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021. Results: The use of bladder catheters (OR 79.30; p < 0.0001) and central venous catheters (OR, 45.12; p < 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p < 0.0001) and prolonged ICU stay (p < 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p < 0.0001). Conclusion: We suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU.

Stroke and snakebite: case report.

Snakebites are common and lead to potential complications like neuromyopathies and strokes, these last associated with disturbances of blood coagulation. We report on a 65 years old woman of cerebral intraparenchymal hemorrhage associated with snakebite by a Bothrops jararaca that occurred in the Reconcavo of Bahia, BA, Brazil. The patient was submitted to a surgical evacuation of the hematoma, with a good result. This report is accompanied by a revision about the association among snakebite and neurological complications, emphasizing strokes. Statistics reveal a high incidence of snakebite in the world, mainly in tropical countries and gets attention for his socioeconomic impact. The clinical and laboratory characteristics to identify the victims that present a high risk of presenting strokes are discussed in order to identify early those patients, so that they may be treated in a more precocious and effective way.

Stroke and snakebite: case report

Snakebites are common and lead to potential complications like neuromyopathies and strokes, these last associated with disturbances of blood coagulation. We report on a 65 years old woman of cerebral intraparenchymal hemorrhage associated with snakebite by a Bothrops jararaca that occurred in the Reconcavo of Bahia, BA, Brazil. The patient was submitted to a surgical evacuation of the hematoma, with a good result. This report is accompanied by a revision about the association among snakebite and neurological complications, emphasizing strokes. Statistics reveal a hight incidence of snakebite in the world, mainly in tropical countries and gets attention for his socioeconomic impact. The clinical and laboratorial characteristics to identify the victims that present a high risk of presenting strokes are discussed in order to identify early those patients, so that they may be treated in a more precocious and effective way.

Acidentes ofídicos são comuns e trazem como potenciais complicações neuromiopatias e doenças cerebrovasculares, estas últimas associadas a distúrbios da coagulação sanguínea. Relatamos sobre uma mulher de 65 anos com hemorragia cerebral intraparenquimatosa associado a acidente ofídico por Bothrops jararaca, ocorrido no Recôncavo Baiano, BA, Brasil. A paciente foi submetida à craniotomia para evacuação cirúrgica do hematoma, com bom desfecho final. Este relato é acompanhado de revisão sobre a associação entre ofidismo e complicações neurológicas, com enfoque as doenças cerebrovasculares. As estatísticas impressionam pela alta incidência de acidente ofídico no mundo, principalmente em países tropicais e chama atenção o seu impacto sócio-econômico. Discutimos os achados clínicos e laboratoriais que identificam quais vítimas apresentam maior risco de apresentar complicações cerebrovasculares a fim de se identificar precocemente esses pacientes, para que possam ser tratados de forma mais precoce e eficaz.