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1.
Rev. enferm. UERJ ; 31: e70737, jan. -dez. 2023.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1437028

ABSTRACT

Objetivo: descrever características clínico-epidemiológicas dos casos de COVID-19 em profissionais de enfermagem e analisar fatores associados aos óbitos. Método: estudo transversal realizado com casos e óbitos por COVID-19 em profissionais de enfermagem registrados no período entre abril de 2020 e março de 2021 no estado do Maranhão. Utilizou-se a estatística descritiva e modelos de regressão logística. Resultados: verificaram-se 2.116 casos de COVID-19 em profissionais de enfermagem, a maioria eram técnicos (63,23%), sexo feminino (86,48%), raça/cor preta/parda (48,20%), na faixa etária de 31 a 40 anos (40,69%) e média de idade de 38,11 anos (DP=9,58). A hipertensão arterial sistêmica foi a principal comorbidade apresentada (62,03%). Os fatores de risco para o óbito foram: idade >60 anos, comorbidades como hipertensão arterial sistêmica, diabetes mellitus e obesidade. Conclusão: esses dados podem direcionar intervenções em saúde mais efetivas com intuito de minimizar os riscos de infecção e os danos à saúde desses trabalhadores(AU)


Objective: to identify clinical-epidemiological characteristics of two cases of COVID-19 in nursing professionals and to analyze factors associated with deaths. Method: a cross-sectional study was carried with cases and deaths from COVID-19 in nursing professionals registered between April 2020 and March 2021 in Maranhão. Descriptive statistics and logistic regression models were used. Results: we verified 2,116 cases of COVID-19 in nursing professionals, mostly among technicians (63.23%), females (86.48%), of black/white/brown ethnicity (48.20%), aged from 31 to 40 years (40.69%), and with a mean age of 38.11 years (SD=9.58). Systemic arterial hypertension was the main comorbidity (62.03%). The risk factors for death are age >60 years and comorbidities such as systemic arterial hypertension, diabetes mellitus, and obesity. Conclusion: our findings can support more effective health interventions to minimize the risk of infection and damage to the health of these workers(AU)


Objetivo: identificar las características clínico-epidemiológicas de casos de COVID-19 en profesionales de enfermería y analizar los factores asociados a muertes. Método: se realizó un estudio transversal con casos y muertes por COVID-19 en profesionales de enfermería registrados entre abril de 2020 y marzo de 2021 en Maranhão. Se utilizaron estadísticas descriptivas y modelos de regresión logística. Resultados: verificamos 2.116 casos de COVID-19 en profesionales de enfermería, en su mayoría técnicos (63,23%), del sexo femenino (86,48%), de etnia negra/blanca/morena (48,20%), con edad de 31 a 40 años (40,69%) y edad media de 38,11 años (DE=9,58). La hipertensión arterial sistémica fue la principal comorbilidad presentada (62,03%). Los factores de riesgo de muerte fueron: edad > 60 años y comorbilidades como hipertensión arterial sistémica, diabetes mellitus y obesidad. Conclusión: esos hallazgos pueden respaldar intervenciones de salud más efectivas para minimizar el riesgo de infección y daño a la salud de estos trabajadores(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Occupational Risks , COVID-19/epidemiology , Nurses , Brazil , Cross-Sectional Studies , COVID-19/mortality
2.
Arch. latinoam. nutr ; 73(4): 276-286, dic. 2023. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1537477

ABSTRACT

Introducción. La investigación sobre la pandemia de COVID-19, se ha estudiado en tiempo real, ha sido y sigue siendo reveladora. Objetivo. Analizar la morbilidad y la mortalidad por COVID-19, asociadas a factores de riesgo metabólicos en población no indígena e indígena de México. Materiales y métodos. Utilizamos la Base Nacional de Datos COVID-19, durante los años críticos 2020-2021- 2022. Se trabajó con 5.380.247 casos que representaron la población total de positivos al SARS-CoV-2. Se analizaron las discrepancias entre las prevalencias de población no indígena, población indígena, defunción y no defunción. Se definió población indígena, con la clasificación oficial de auto-identificación. Se aplicó el modelo de regresión logística para determinar el riesgo de morir para cada variable: enfermedades cardiovasculares, hipertensión, diabetes, obesidad, sexo, edad y condición indígena. El análisis de multicolinealidad se analizó a través de la prueba de asociación Phi para variables dicotómicas y a través del ajuste de Nagelkerke. Resultados. En los positivos totales 99,2% fue población no indígena y 0,8% indígenas, mientras su porcentaje de letalidad fue de 5,8% y 11,1% respectivamente. En ambos grupos, murieron más hombres (61,5%) que mujeres (38,5%) y las edades de mayor defunción fueron 60 a 79 años. La mortalidad por enfermedades cardiovasculares fue la de mayor incidencia, 26,6% en población general y 32,3% en indígena; por diabetes 22,1% y 27,9%; hipertensión 20,0% y 26,7%y la obesidad 11, 3% y 17,4% respectivamente. Los análisis de regresión logística se ajustaron por sexo, edad y condición indígena. El condicionante de mayor riesgo de muerte, fueron las comorbilidades metabólicas y el de menor riesgo, la condición indígena. Conclusiones. El impacto de la pandemia por COVID-19 fue más grave cuando hubo padecimientos metabólicos tanto en la población no indígena como en la indígena(AU)


Introduction. Research on the COVID-19 pandemic, studied in real time, has been and continues to be revealing. Objective. To analyze morbidity and mortality from COVID-19, associated with metabolic risk factors in non-indigenous and indigenous populations of Mexico. Materials and methods. We use the National COVID-19 Database, during the critical years 2020-2021-2022. We worked with 5,380,247 cases that represented the total population of SARS-CoV-2 positives. The discrepancies between the prevalence of non-indigenous population, indigenous population, death and non-death were analyzed. The indigenous population was defined, with the official self-identification classification. The logistic regression model was applied to determine the risk of dying for each variable: cardiovascular diseases, hypertension, diabetes, obesity, sex, age and indigenous status. The multicollinearity analysis was analyzed through the Phi association test for dichotomous variables and through the Nagelkerke adjustment. Results. Of the total positives, 99.2% were non-indigenous people and 0.8% were indigenous, while their fatality percentage was 5.8% and 11.1% respectively. In both groups, more men (61.5%) than women (38.5%) died and the ages of greatest death were 60 to 79 years. Mortality from cardiovascular diseases was the one with the highest incidence, 26.6% in the general population and 32.3% in the indigenous population; due to diabetes 22.1% and 27.9%; hypertension 20.0% and 26.7% and obesity 11.3% and 17.4% respectively. Logistic regression analyzes were adjusted for sex, age, and indigenous status. The condition with the highest risk of death was metabolic comorbidities and the lowest risk was indigenous status. Conclusions. The impact of the COVID-19 pandemic was more serious when there were metabolic disorders in both the non-indigenous and indigenous populations(AU)


Subject(s)
Humans , Male , Adult , Middle Aged , Indigenous Peoples , COVID-19/mortality , Metabolic Diseases , Cardiovascular Diseases , Diabetes Mellitus , Sociodemographic Factors , Hypertension , Obesity
3.
Rev. epidemiol. controle infecç ; 13(4): 188-194, out.-dez. 2023. ilus
Article in English, Portuguese | LILACS | ID: biblio-1532210

ABSTRACT

Background and Objectives: during the COVID-19 pandemic, the number of critical patients requiring intensive care increased considerably, resulting in an increase in infections due to multi-resistant microorganisms. In Brazil, in 2021, due to the high demand for polymyxin B use, there was a national shortage of the medication. One strategy used to overcome this situation was aminoglycoside use. The work aimed to analyze the impact of replacing polymyxin B with amikacin and gentamicin in the final stage of patients. Method: an analytical study with an observational, cross-sectional design, with a quantitative approach, through a retrospective analysis through the analysis of medical records, with the primary stages being discharges or deaths. Results: mortality was similar between the group treated with aminoglycoside and the group treated with polymyxin B. Within the aminoglycoside group, mortality was higher in the group that had bacteria resistant to the drug than in the group that had infection with an organism sensitive to this drug. Mortality was not affected by comorbidities, age, or number of hospital infections. The main factor that led to the need for dialysis was the combination of two nephrotoxic medications. Conclusion: two hypotheses emerged: the first would be that replacing polymyxin B with aminoglycosides did not impact mortality; the other would be that, regardless of the antibiotic group used, patients had a high risk of death. Despite sample limitations, the study corroborates the adoption of strategies for the rational use of antimicrobials.(AU)


Justificativa e Objetivos: durante a pandemia de COVID-19, o número de pacientes críticos que necessitaram de cuidados intensivos aumentou consideravelmente, resultando em aumento de infecções por microrganismos multirresistentes. No Brasil, em 2021, devido à grande demanda pelo uso da polimixina B, houve escassez nacional do medicamento. Uma estratégia utilizada para superar essa situação foi o uso de aminoglicosídeos. O trabalho teve como objetivo analisar o impacto da substituição da polimixina B por amicacina e gentamicina na fase final dos pacientes. Método: estudo analítico com desenho observacional, transversal, com abordagem quantitativa, por meio de análise retrospectiva por meio de análise de prontuários, sendo as etapas primárias as altas ou óbitos. Resultados: a mortalidade foi semelhante entre o grupo tratado com aminoglicosídeo e o grupo tratado com polimixina B. Dentro do grupo aminoglicosídeo, a mortalidade foi maior no grupo que apresentava bactérias resistentes ao medicamento do que no grupo que apresentava infecção por organismo sensível a este medicamento. medicamento. A mortalidade não foi afetada por comorbidades, idade ou número de infecções hospitalares. O principal fator que levou à necessidade de diálise foi a combinação de dois medicamentos nefrotóxicos. Conclusão: surgiram duas hipóteses: a primeira seria que a substituição da polimixina B por aminoglicosídeos não impactou a mortalidade; a outra seria que, independentemente do grupo de antibióticos utilizado, os pacientes apresentavam alto risco de morte. Apesar das limitações amostrais, o estudo corrobora a adoção de estratégias para o uso racional de antimicrobianos.(AU)


Antecedentes y Objetivos: durante la pandemia de COVID-19, el número de pacientes críticos que requirieron cuidados intensivos aumentó considerablemente, resultando en un aumento de infecciones por microorganismos multirresistentes. En Brasil, en 2021, debido a la alta demanda del uso de polimixina B, hubo escasez nacional del medicamento. Una estrategia utilizada para superar esta situación fue el uso de aminoglucósidos. El trabajo tuvo como objetivo analizar el impacto de la sustitución de la polimixina B por amikacina y gentamicina en la etapa final de los pacientes. Método: estudio analítico con diseño observacional, transversal, con enfoque cuantitativo, mediante un análisis retrospectivo mediante el análisis de historias clínicas, siendo las etapas primarias las altas o defunciones. Resultados: la mortalidad fue similar entre el grupo tratado con aminoglucósido y el grupo tratado con polimixina B. Dentro del grupo de aminoglucósido, la mortalidad fue mayor en el grupo que tenía bacterias resistentes al fármaco que en el grupo que tenía infección con un organismo sensible a este. droga. La mortalidad no se vio afectada por las comorbilidades, la edad o el número de infecciones hospitalarias. El principal factor que llevó a la necesidad de diálisis fue la combinación de dos medicamentos nefrotóxicos. Conclusión: surgieron dos hipótesis: la primera sería que la sustitución de polimixina B por aminoglucósidos no impactó la mortalidad; la otra sería que, independientemente del grupo de antibióticos utilizado, los pacientes tenían un alto riesgo de muerte. A pesar de las limitaciones de la muestra, el estudio corrobora la adopción de estrategias para el uso racional de antimicrobianos.(AU)


Subject(s)
Humans , Polymyxin B/supply & distribution , COVID-19/mortality , Aminoglycosides/therapeutic use , Cross-Sectional Studies , Drug Utilization
4.
Rev. chil. infectol ; 40(6): 626-633, dic. 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1529992

ABSTRACT

INTRODUCCIÓN: La mortalidad por pacientes por COVID-19 grave que desarrollaban neumonía grave y síndrome de dificultad respiratoria agudo (SDRA) grave ha sido significativa a pesar del tratamiento oportuno. Es importante determinar predictores tempranos de enfermedad que nos ayuden a estratificar aquellos pacientes con mayor riesgo de fallecer. Se pretende estudiar el comportamiento del puntaje APP (APPS) como predictor de ello, basados en algunos reportes de uso y utilidad en el SDRA. no COVID-19. OBJETIVO: Determinar si el APPS es útil como predictor de mortalidad en SDRA. por COVID-19 grave. PACIENTES Y MÉTODO: Se realizó un estudio tipo cohorte retrospectivo, incluyendo pacientes de la Unidad de Cuidados Intensivos (UCI), con SDRA. por COVID-19 grave, que ingresaron a la UCI del Hospital Regional Docente de Trujillo (HRDT) en el período abril 2020- abril 2021. Se evalúo la utilidad del APPS como predictor de mortalidad em dicha población. RESULTADOS: El APPS demostró ser un factor asociado a mortalidad en pacientes con SDRA. y COVID-19 grave (RPa 1,34; IC 95% 1,16 a 1,56; p < 0,001). Además, encontramos que, al realizar un modelo de predicción ajustado por edad, sexo, SOFA, APPS, shock, Indice de Charlson (ICh), se comportan como factores asociados a mortalidad el APPS, el sexo masculino (RPa: 1,48; IC 95% 1,09 a 2,049; p < 0,05) y el ICh (RPa: 1,11; IC 95% 1,02 a 1,21; p < 0,05). CONCLUSIÓN: El APPS, el sexo masculino y el ICh son predictores de mortalidad en SDRA. por COVID-19 grave.


BACKGROUND: Mortality in patients with severe COVID-19 who developed severe pneumonia and severe Acute Respiratory Distress Syndrome (ARDS) has been significant despite timely treatment. It is important to determine early predictors of disease that help us to stratify those patients with a higher risk of death. It is intended to study the behavior of the APPS score as a predictor of this, based on some reports of use and usefulness in non-COVID-19 ARDS. AIM: To determine if the APP score is useful as a predictor of mortality in ARDS due to severe COVID-19. METHOD: A retrospective cohort study was carried out, including patients from the Intensive Care Unit (ICU) with ARDS due to severe COVID-19 who were admitted to the ICU of the Trujillo Regional Teaching Hospital (HRDT) in the period March 2020 to March 2021. The usefulness of the APP score as a predictor of mortality in mentioned population was evaluated. RESULTS: The APP score proved to be a factor associated with mortality in patients with ARDS and severe COVID-19 (APR 1.34; 95% CI 1.16 to 1.56; p < 0.001). We also found that when performing a prediction model adjusted for age, sex, SOFA, APP score, shock and Charlson Index (ICh) we found that the APP score, male sex (APR: 1.48; 95% CI 1.09 to 2.049; p < 0.05) and the ICh behave as factors associated with mortality (RPa: 1.11; 95% CI 1.02 to 1.21; p < 0.05). CONCLUSION: The APP score, male sex, and ICh are predictors of mortality in ARDS due to severe COVID-19.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Respiratory Distress Syndrome, Newborn/mortality , COVID-19/complications , Multivariate Analysis , Predictive Value of Tests , Retrospective Studies , ROC Curve , Hospital Mortality , COVID-19/mortality , Intensive Care Units
5.
Rev. chil. infectol ; 40(6): 650-656, dic. 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1529995

ABSTRACT

INTRODUCCIÓN: La evolución de la virulencia ha despertado el interés de la biología evolutiva por décadas. Se trata de co-evolución entre agentes patógenos y sus hospederos. Se han planteado diferentes hipótesis para la evolución de la virulencia, entre ellas la evolución con un compromiso virulencia-transmisión. OBJETIVO: Estudiar la evolución de la letalidad y la transmisión del SARS CoV-2 en Chile, con la hipótesis que ha existido un compromiso con disminución de la letalidad y aumento de la transmisión de esta durante la epidemia. RESULTADOS: La letalidad diaria en Chile disminuyó claramente. Aunque no se encontró correlación entre la letalidad diaria y el número reproductivo efectivo, el número reproductivo efectivo máximo asociado a cada variante viral, presentó un aumento claro desde la aparición de la variante γ en adelante (δ y O) en Chile. CONCLUSIÓN: Este estudio muestra una evolución de la virulencia con un compromiso virulenciatransmisión. Esto puede ser explicado en gran parte por la evolución viral, pero el cambio en letalidad también puede ser afectado por las intervenciones no farmacológicas y farmacológicas realizadas por la población humana.


BACKGROUND: The evolution of virulence has aroused the interest of evolutionary biology for decades. It is about co-evolution between pathogens and their hosts. Different hypotheses have been put forward for the evolution of virulence, including evolution with a virulence-transmission trade-off. AIM: To study the evolution of the fatality rate and transmission of SARS CoV-2 in Chile, with the hypothesis that there has been a trade-off to a decrease in lethality and an increase in its transmission during the epidemic. RESULTS: The daily fatality rate in Chile clearly decreased. Although no correlation was found between daily fatality rate and effective reproductive number, the maximum effective reproductive number associated with each viral variant showed a clear increase from the appearance of the γ variant onwards (δ and O) in Chile. CONCLUSION: This study shows an evolution of virulence with a virulence-transmission trade-off. This can be largely explained by viral evolution, but the change in lethality can also be affected by non-pharmacological and pharmacological interventions carried out by the human population.


Subject(s)
Humans , SARS-CoV-2/pathogenicity , COVID-19/mortality , COVID-19/transmission , Virulence , Chile/epidemiology
6.
Rev. chil. infectol ; 40(5): 472-480, oct. 2023. tab
Article in Spanish | LILACS | ID: biblio-1521873

ABSTRACT

INTRODUCCIÓN: La introducción progresiva de vacunas contra SARS-CoV-2 a partir de 2021, priorizando grupos de mayor edad, podría implicar un cambio en el perfil de pacientes hospitalizados por COVID-19 en el tiempo. OBJETIVO: Comparar las características y evolución de pacientes adultos hospitalizados por COVID-19 en un período anterior en 2020 (PER1) y otro posterior al inicio de la vacunación masiva contra SARS-CoV-2 (PER2). PACIENTES Y MÉTODOS: Se registró edad, género, comorbilidades, complicaciones y evolución de los pacientes hospitalizados por COVID-19 en una clínica privada, en Santiago, Chile. Se calculó el puntaje de gravedad y riesgo nutricional. RESULTADOS: En PER2, los pacientes fueron de menor edad, pero con comorbilidades similares al PER1, excepto por mayor malnutrición por exceso. Los pacientes del PER2 no vacunados requirieron más ventilación mecánica (38,9 vs. 14,3%, p = 0,03) y evolucionaron más gravemente (puntaje 6) que aquellos adecuadamente inmunizados (puntaje 5, p = 0,048). Las variables que más predijeron mortalidad fueron edad > 60 años (OR 28.995) y presencia de riesgo nutricional (OR 5.246). DISCUSIÓN: El cambio en el perfil y evolución de los pacientes hospitalizados con COVID-19 está asociado con la secuencia de priorización de vacunas contra SARS-CoV-2, cuyo efecto redujo las hospitalizaciones y gravedad de COVID-19 en adultos mayores.


BACKGROUND: During the COVID-19 pandemic, the early prioritization of SARS-CoV-2 vaccines for older adults may have affected the characteristics of hospitalized COVID-19 patients over time. AIM: To compare the clinical characteristics and outcomes of adult patients admitted for COVID-19 before (PER1) and after (PER2) the initiation of mass vaccination for SARS-CoV-2. METHODS: Data on age, gender, comorbidities, complications, and outcomes of adult patients hospitalized for COVID-19 in a private clinic of Santiago, Chile, were collected. Scores for COVID-19 severity and nutritional risk were calculated. RESULTS: In PER2, patients were younger but had similar comorbidities, except for a higher prevalence of overweight and obesity compared to PER1. Unvaccinated COVID-19 patients in PER2 required more invasive ventilatory support (38.9% vs. 14.3%, p = 0.03) and had a higher severity score (six) than vaccinated patients (five, p = 0.048). The variables that best predicted mortality were age > 60 years (OR 28,995) and the presence of nutritional risk (OR 5,246). DISCUSSION: Changes in the profile and outcomes of hospitalized patients during the COVID-19 pandemic are associated with the prioritization of SARS-CoV-2 vaccines and their protective effect in reducing hospitalizations and disease severity in older adults.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , COVID-19 Vaccines/administration & dosage , COVID-19/mortality , COVID-19/prevention & control , Severity of Illness Index , Comorbidity , Clinical Evolution , Nutritional Status , Vaccination/statistics & numerical data , Risk Assessment , COVID-19/epidemiology , Hospitalization/statistics & numerical data
7.
Salud trab. (Maracay) ; 31(1): 73-86, jun. 2023. tab., ilus.
Article in Spanish | LILACS, LIVECS | ID: biblio-1452223

ABSTRACT

La pandemia por COVID-19 resultó un problema para la salud pública mundial, que impactó particularmente al sector de trabajadores que debían trabajar y estar expuestos durante el periodo de cuarentena. Objetivo, analizar la incidencia de COVID-19 y sus características en trabajadores(as) activos(as) durante 34 semanas. Investigación descriptiva y transversal. Población constituida por todos los trabajadores(as) activos de sectores priorizados, con diagnóstico confirmado de COVID-19. De los 1.186 casos confirmados, 658 casos (55%) correspondió a trabajadores activos, una incidencia de 1,7 casos x 1000 (mayor a la esperada), con predominio en trabajadores(as) del sector salud (267casos), choferes del transporte y trabajadores de funerarias (253 casos). El 68,7% menor de 40 años y predominio del sexo masculino (61,2%). En el personal de salud, el 30% correspondió a personal de enfermería y 22% en médicos. La tasa de mortalidad en la población de trabajadores activos fue de 0,07 x cada 1000, con un índice de mortalidad de 0,05 y un índice de recuperación del 95,5%, comportamiento similar al de la población general. Sin embargo, la tasa de letalidad (trabajadores activos positivos fallecidos) fue del 4,4% (29 casos), donde el 75% (22/29) fueron enfermeras y médicos, lo que confirmó al sector salud y trabajadores(as) de servicios, como población trabajadora altamente expuesta y vulnerable, lo que justificó priorizar las medidas de prevención en estos trabajadores, al iniciar el sistema de vigilancia epidemiológica, la vacunación y la dotación con uso adecuado de la protección personal(AU)


The COVID-19 Pandemic was a problem for global public health, which particularly impacted the sector of workers who had to work and were exposed during the quarantine period. The objective was to analyze the incidence of COVID- 19 and its characteristics in active workers during 34 weeks. Descriptive and cross-sectional research. Population made up of all active workers in prioritized sectors, with a confirmed diagnosis of COVID-19. Of the 1,186 confirmed cases, 658 cases (55%) corresponded to active workers, an incidence of 1.7 cases per 1,000 (higher than expected), with a predominance of workers in the health sector (267 cases), transport drivers and funeral home workers (253 cases). 68.7% under 40 years of age and predominance of the male sex (61.2%). In health personnel, 30% corresponded to nursing personnel and 22% to doctors. The mortality rate in the population of active workers was 0.07 x every 1000, with a mortality rate of 0.05 and a recovery rate of 95.5%, behavior similar to that of the general population. However, the fatality rate (deceased positive active workers) was 4.4% (29 cases), where 75% (22/29) were nurses and doctors, which confirmed the health sector and service workers, as a highly exposed and vulnerable working population, which justified prioritizing prevention measures in these workers, by initiating the epidemiological surveillance system, vaccination and provision with adequate use of personal protection(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , COVID-19/mortality , COVID-19/epidemiology , Venezuela/epidemiology , Women, Working/statistics & numerical data , Cross-Sectional Studies , Cohort Studies , Occupational Groups
8.
Rev. epidemiol. controle infecç ; 13(1): 53-61, jan.-mar. 2023. ilus
Article in English | LILACS | ID: biblio-1512761

ABSTRACT

Background and objective: new population-level studies are needed to better assess the relationship between physical inactivity and mortality from COVID-19. The aim of the study was to evaluate the correlation between population prevalence of physical activity and standardized mortality rates by COVID-19 in Brazilian capital cities and the Federal District. Methods: this is an ecological study, whose analysis is secondary. The prevalence of physical inactivity, insufficient physical activity, and physical activity during free time was obtained from the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey 2019 (VIGITEL), according to minutes spent on leisure, commuting, and household activities. The COVID-19 mortality data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), adding the accumulated deaths until December 31, 2020. The resident population was estimated from the Instituto Brasileiro de Geografia e Estatística (IBGE) for the year 2020. Pearson Correlation evaluated the correlation between the prevalence of different physical activity practices and the standardized mortality rate from COVID-19, in total, and according to age groups. Results: there was a significant positive correlation (r = 0.420; p = 0.029) between the overall prevalence of insufficient physical activity and the standardized COVID-19 mortality rate. No correlation was observed between the other prevalence of physical activity and the standardized mortality rate from COVID-19. Conclusion: there was a correlation between insufficient levels of physical activity and the standardized mortality rate from COVID-19 in people living in Brazilian capital cities.(AU)


Justificativa e objetivo: novos estudos em nível populacional são necessários para avaliar a relação entre inatividade física e mortalidade por COVID-19. O objetivo deste estudo foi avaliar a correlação entre as prevalências populacionais de prática de atividade física e as taxas padronizadas de mortalidade por COVID-19 nas cidades capitais brasileiras e no Distrito Federal. Métodos: trata-se de um estudo ecológico, cuja análise é secundária. As prevalências de inatividade física, atividade física insuficiente e atividade física no tempo livre foram obtidas do inquérito Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico 2019 (VIGITEL). Os dados de mortalidade por COVID-19 foram obtidos do Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe), somando os óbitos acumulados até 31 de dezembro de 2020. A população residente foi estimada a partir do Instituto Brasileiro de Geografia e Estatística (IBGE) para o ano de 2020. A Correlação de Pearson avaliou a correlação entre a prevalência de diferentes práticas de atividade física e a taxa padronizada de mortalidade por COVID-19, no total e segundo faixas etárias. Resultados: houve correlação significativa positiva (r = 0,420; p = 0,029) entre a prevalência geral de atividade física insuficiente e a taxa padronizada de mortalidade por COVID-19. Não foi observada correlação entre as demais prevalências de prática de atividade física e taxa padronizada de mortalidade por COVID-19. Conclusão: houve correlação entre os níveis insuficientes de atividade física e a taxa padronizada de mortalidade por COVID-19 em pessoas que vivem nas cidades capitais brasileiras.(AU)


Justificación y objetivo: nuevos estudios a nivel poblacional son necesarios para evaluar la relación entre la inactividad física y la mortalidad por COVID-19. Evaluar la correlación entre la prevalencia poblacional de actividad física y las tasas estandarizadas de mortalidad por COVID-19 en las capitales brasileñas y el Distrito Federal. Métodos: se trata de un estudio ecológico, cuyo análisis es secundario. Las prevalencias de sedentarismo, actividad física insuficiente y actividad física en el tiempo libre se obtuvieron de la Encuesta Telefónica de Vigilancia de Factores de Riesgo y Protección de Enfermedades Crónicas 2019 (VIGITEL). Los datos de mortalidad por COVID-19 se obtuvieron del Sistema de Información de Vigilancia Epidemiológica de Influenza (SIVEP-Gripe), sumando las muertes acumuladas hasta el 31 de diciembre de 2020. La población residente se estimó del Instituto Brasileiro de Geografia e Estatística (IBGE) para el año. 2020. Pearson Correlation evaluó la correlación entre la prevalencia de diferentes prácticas de actividad física y la tasa de mortalidad estandarizada por COVID-19, en total y según grupos de edad. Resultados: hubo una correlación positiva significativa (r = 0,420; p = 0,029) entre la prevalencia general de actividad física insuficiente y la tasa de mortalidad estandarizada por COVID-19. No se observó correlación entre la otra prevalencia de actividad física y la tasa de mortalidad estandarizada por COVID-19. Conclusión: hubo una correlación entre los niveles insuficientes de actividad física y la tasa de mortalidad estandarizada por COVID-19 en personas que viven en las capitales brasileñas.(AU)


Subject(s)
Humans , Exercise , Ecological Studies , COVID-19/mortality
9.
Article in Spanish | LILACS, CUMED | ID: biblio-1508244

ABSTRACT

Introducción: La COVID-19 representa un panorama particularmente estremecedor en los adultos mayores, debido a la alta morbilidad y mortalidad. Diseñar acciones para su atención integral constituye una prioridad de la salud pública en Cuba y un poderoso instrumento para la prevención de esta enfermedad. Objetivo: Diseñar acciones comunitarias e intersectoriales para la COVID-19 en el adulto mayor. Métodos: Se realizó un estudio cuasiexperimental de intervención mediante acciones comunitarias e intersectoriales para prevenir la COVID-19 en los adultos mayores pertenecientes al consultorio 16 del Policlínico Guillermo Tejas Silva, en el período de abril a diciembre del 2020. El universo estuvo constituido por 134 gerontes y la muestra de 110. Se desarrolló en tres etapas. Se evaluó el impacto de la intervención. Resultados: Predominaron las gerontes femeninas (50,9 por ciento), las edades de 60-64 años (32,2 por ciento) y los independientes activos (45,5 por ciento). Con la aplicación de la estrategia se aumentó el nivel de conocimiento de los seniles (91,8 por ciento), se controló el 100 por ciento de las enfermedades, se redujeron los trastornos emocionales en un 78,4 por ciento y se diseñaron 185 acciones comunitarias para prevenir la COVID-19 en el adulto mayor. Conclusiones: La sostenibilidad en el control de la COVID -19 en el adulto mayor requiere de la movilización y participación de todos los sectores de la sociedad y la economía, unidos en un esfuerzo conjunto que sustente las acciones comunitarias(AU)


Introduction: COVID-19 is a particularly frightening scenario for elderly adults, due to high morbidity and mortality. Designing actions for the comprehensive management of this disease is a public health priority in Cuba and a powerful instrument for preventing it. Objective: To design community and intersectoral actions for COVID-19 in elderly people. Methods: A quasiexperimental intervention study was carried out by means of community and intersectoral actions for preventing COVID-19 in elderly people from the family doctor's office 16 of Policlínico Guillermo Tejas Silva, in the period from April to December 2020. The study universe was made up of 134 elderly people and the sample was 110. It was developed in three stages. The impact of the intervention was evaluated. Results: Female elderly people were predominant (50.9 percent), together with ages 60-64 years (32.2 percent) and the condition of active independent (45.5 percent) with the implementation of the strategy, the level of knowledge of the senile increased (91.8 percent), 100 percentof the diseases were controlled, emotional disorders were reduced by 78.4 percent, and 185 community actions were designed to prevent COVID-19 in the elderly people. Conclusions: Sustainability in the control of COVID-19 in the elderly people requires the mobilization and involvement of all sectors of society and the economy, united in a joint effort that sustains community actions(AU)


Subject(s)
Humans , Male , Female , COVID-19/mortality , COVID-19/transmission , COVID-19/epidemiology , Cuba
10.
REME rev. min. enferm ; 27: 1531, jan.-2023. Tab., Fig.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1523824

ABSTRACT

Objetivo: analisar a relação entre a raça/cor da pele e a morbimortalidade por COVID-19 no estado de São Paulo-SP. Métodos: Estudo ecológico, retrospectivo e analítico, cujos dados foram coletados no Sistema Estadual de Análise de Dados (SEADE) do Governo do Estado de São Paulo e correspondem ao período de fevereiro de 2020 a setembro de 2021. Na análise de dados, utilizou-se o modelo de regressão com distribuição binomial-negativa múltipla, para comparar a incidência e a mortalidade específica entre as raças/cores de pele. Resultados: ao se compararem as curvas de incidência de COVID-19, houve diferença estatística significativa entre as comparações de todos os grupos de raça/cor da pele. Na comparação entre tendências branca vs parda, o resultado foi p = 0,007; na comparação entre tendências branca vs preta, p = <0,001; na comparação entre tendências parda vs preta, p = 0,003. Porém, quando foram comparadas as tendências de incidência por sexo e faixa etária e as tendências de óbito, não houve diferença estatística. Conclusão: a raça/cor da pele influenciou nas curvas de incidência geral por COVID-19 no estado de São Paulo, porém a não associação com a mortalidade pode estar relacionada com a falta de informação sobre raça/cor/etnia nas fichas de notificação, afetando consequentemente sua disponibilidade nos sistemas de informação, o que reforça a importância da divulgação de dados epidemiológicos oficiais de qualidade.(AU)


Objective: to analyze the relationship between ethnicity/skin color and morbi-mortality from COVID-19 in the state of São Paulo-SP. Methods: ecological, retrospective, and analytical study, whose data were collected from the State Data Analysis System (SE-ADE) of the Government of the State of São Paulo, covering from February 2020 to September 2021. Data analysis used a regression model with multiple binomial negative distribution, to compare the incidence and mortality specific between ethnicities/skin colors. Results: a comparison between the incidence curves of COVID-19 showed a signi-ficant statistical difference between all groups of ethnicity/skin color. In the comparison of trends between white and brown, the result was p = 0.007; in the comparison of trends between white and black, it was p = 0.001; in the comparison of trends between brown and black, p = 0.003. However, when we compare the trends of incidence per sex and age group with death trends, there was no statistical difference. Conclusion: ethnicity/skin color has influenced general incidence curves by COVID-19 in São Paulo. The fact that it was not associated with mortality can be related with the lack of information about ethnicity/color in notification forms, thus affecting the availability of such data in information systems, which reiterates the importance of publicizing quality official epidemiological data.(AU)


Objetivo: analizar la relación entre la raza/color de piel y la morbimortalidad por Covid-19 en el estado de São Paulo-SP.Métodos: estudio ecológico, retrospectivo y analítico, cuyos datos fueron recolectados en el Sistema Estatal de Análisis de Datos (SEADE) del Gobierno del Estado de São Paulo y corresponden al período de febrero de 2020 a septiembre de 2021. Para el análisis de datos se utilizó el modelo de regresión con distribución binomial-negativa múltiple para comparar la incidencia y la mortalidad específica entre las razas/colores de piel.Resultados: al comparar las curvas de incidencia de Covid-19, hubo una diferencia estadística significativa entre las comparaciones de todos los grupos de raza/color de piel, siendo que en la comparación entre tendencias blanca vs parda p= 0,007; comparación entre tendencias blanca vs negra p= <0,001; comparación entre tendencias parda vs negra p= 0,003. Sin embargo, cuando se compararon las tendencias de incidencia por sexo y grupo etario y las tendencias de muerte, no hubo diferencia estadística. Conclusión: la raza/color de piel influyó en las curvas de incidencia general por Covid-19 en el estado de São Paulo, sin embargo, la no-asociación con la mortalidad puede estar relacionada con la falta de información sobre raza/color/etnia en las fichas de notificación, y consecuentemente su disponibilidad en los sistemas de información, reforzando la importancia de la divulgación de datos epidemiológicos oficiales de calidad.(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Aged , Socioeconomic Factors , Indicators of Morbidity and Mortality , Health Information Systems , Data Analysis , COVID-19/mortality , COVID-19/epidemiology , Incidence , Racial Groups
11.
Online braz. j. nurs. (Online) ; 22: e20236645, 01 jan 2023. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1451136

ABSTRACT

OBJETIVO: Avaliar a prevalência e os fatores associados aos óbitos pela COVID-19 em Pernambuco. MÉTODO: Estudo transversal com a utilização de bases dos dados referente ao acompanhamento das notificações por COVID-19 em Pernambuco. RESULTADOS: Prevalência do sexo masculino (54,1%), não idoso (53,0%) com alguma comorbidade (55,6%). Prevaleceram os sintomas gripais (82,5%) e dispneia (80,2%). Entre os fatores associados com a mortalidade, prevaleceram os idosos (OR 3,57; p-valor=0,000), a presença de doenças hepáticas (OR 4,81; p-valor=0,000), doenças renais (OR 2,94; p-valor=0,000) e sobrepeso ou obesidade (OR 2,38; p-valor=0,000), sintomas como dispneia (OR 1,31; p-valor=0,000) e saturação de O2 <95% (OR 1,42; p=valor=0,000). CONCLUSÃO: A prevalência foi de homens, não idosos e com comorbidades. Os principais fatores associados aos óbitos foram a presença de comorbidades e ser idoso.


OBJECTIVE: To evaluate the prevalence and factors associated with deaths due to covid-19 in Pernambuco. METHOD: Cross-sectional study with the use of databases related to the monitoring of COVID-19 notifications in Pernambuco. RESULTS: Prevalence of male sex (54.1%), non-elderly (53.0%) with some comorbidity (55.6%). The flu symptoms prevailed (82.5%) and dyspnea (80.2%). Among the factors associated with mortality, the following prevailed: elderly (OR 3.57; p-value=0.000), presence of hepatic diseases (OR 4.81; p-value=0.000), kidney diseases (OR 2.94; p-value=0.000) and overweight or obesity (OR 2.38; p-value=0.000), symptoms like dyspnea (OR 1.31; p-value=0.000) and O2 saturation <95% (OR 1.42; p=value=0.000). CONCLUSION: The prevalence was men, non-elderly and with comorbidities. The main factors associated with deaths were the presence of the elderly and being elderly.


Subject(s)
Humans , Male , Female , Risk Factors , Mortality , COVID-19/mortality , Cross-Sectional Studies
12.
Rev. saúde pública (Online) ; 57(supl.1): 2s, 2023. tab, graf
Article in English | LILACS | ID: biblio-1442145

ABSTRACT

ABSTRACT OBJECTIVE To investigate the relationship between covid-19 hospital mortality and risk factors, innovating by considering contextual and individual factors and spatial dependency and using data from the city of São Paulo, Brazil. METHODS The study was performed with a spatial hierarchical retrospective cohort design using secondary data (individuals and contextual data) from hospitalized patients and their geographic unit residences. The study period corresponded to the first year of the pandemic, from February 25, 2020 to February 24, 2021. Mortality was modeled with the Bayesian context, Bernoulli probability distribution, and the integrated nested Laplace approximations. The demographic, distal, medial, and proximal covariates were considered. RESULTS We found that per capita income, a contextual covariate, was a protective factor (odds ratio: 0.76 [95% credible interval: 0.74-0.78]). After adjusting for income, the other adjustments revealed no differences in spatial dependence. Without income inequality in São Paulo, the spatial risk of death would be close to one in the city. Other factors associated with high covid-19 hospital mortality were male sex, advanced age, comorbidities, ventilation, treatment in public healthcare settings, and experiencing the first covid-19 symptoms between January 24 and February 24, 2021. CONCLUSIONS Other than sex and age differences, geographic income inequality was the main factor responsible for the spatial differences in the risk of covid-19 hospital mortality. Investing in public policies to reduce socioeconomic inequities, infection prevention, and other intersectoral measures should focus on lower per capita income, to control covid-19 hospital mortality.


Subject(s)
Humans , Male , Female , Socioeconomic Factors , Retrospective Studies , Risk Factors , Bayes Theorem , Hospital Mortality , COVID-19/mortality , Hospitalization , Brazil/epidemiology
13.
Rev. chil. enferm. respir ; 39(3): 203-215, 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1521829

ABSTRACT

La enfermedad respiratoria aguda por coronavirus SARS-CoV-2 (COVID-19) se ha convertido en un grave problema de salud pública a nivel mundial. Objetivos: Examinar el uso de recursos sanitarios, riesgo de complicaciones y muerte en pacientes adultos con enfermedades respiratorias crónicas atendidos por COVID-19. Métodos: Estudio clínico descriptivo prospectivo realizado en pacientes adultos atendidos por COVID-19 en la Red de Salud UC Christus entre el 1 de abril y 31 de diciembre de 2020. Resultados: Se evaluaron 2.160 pacientes adultos, edad: 47 ± 17 años (rango: 18-100), 51,3% sexo masculino, 43,8% tenía comorbilidades, especialmente hipertensión (23,2%), diabetes (11,7%) y enfermedades respiratorias crónicas: asma (5%), EPOC (1,4%) y enfermedad pulmonar difusa (EPD: 0,8%). Los pacientes adultos con enfermedades respiratorias crónicas tuvieron mayor riesgo de hospitalización y uso de oxígeno suplementario; sin embargo, la evolución de los pacientes asmáticos y la sobrevida a los doce meses fue similar a los pacientes sin comorbilidades atendidos por COVID-19, mientras que en los pacientes con EPOC y EPD la admisión a la unidad de paciente crítico y riesgo de muerte fueron más elevados. En el análisis multivariado, los principales predictores clínicos asociados al riesgo de muerte en el seguimiento a doce meses en pacientes adultos con COVID-19 fueron la edad y admisión al hospital, mientras que el asma fue un factor protector. Conclusión: Los pacientes asmáticos tuvieron bajo riesgo de complicaciones y muerte asociados a COVID-19; mientras que los pacientes con EPOC y EPD tuvieron mayor riesgo de complicaciones y muerte en el seguimiento a largo plazo.


The acute respiratory disease associated to coronavirus SARS-CoV-2 (COVID-19) has become a serious public health problem worldwide. Objectives: To examine the use of healthcare resources, risk of complications and death in adult patients with chronic respiratory diseases treated for COVID-19. Methods: Prospective descriptive clinical study conducted in adult patients treated for COVID-19 in the UC Christus Healthcare Network between April 1 and December 31, 2020. Results: 2,160 adult patients were evaluated, age: 47 ± 17 years-old (range: 18-100), 51.3% male, 43.8% had comorbidities, especially hypertension (23.2%), diabetes (11.7%), and chronic respiratory diseases: asthma (5%), COPD (1,4%) and interstitial lung disease (ILD: 0.8%). Adult patients with chronic respiratory diseases were at higher risk for hospitalization and use of supplemental oxygen; however, the evolution of asthmatic patients and survival at twelve months was similar to that of adult patients without comorbidities treated for COVID-19, while in patients with COPD and ILD admission to the critical care unit and risk of death were higher. In the multivariate analysis, the main clinical predictors associated to 12-month mortality risk in adult patients with COVID-19 were age and hospital admission, while asthma was a protective factor. Conclusion: Asthmatic patients had minor risk of complications and mortality associated with COVID-19; while patients with COPD and ILD had a significant higher risk of complications and 12-month mortality.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Asthma/complications , Lung Diseases, Interstitial/complications , Pulmonary Disease, Chronic Obstructive/complications , COVID-19/complications , Asthma/mortality , Asthma/therapy , Survival Analysis , Multivariate Analysis , Prospective Studies , Follow-Up Studies , Lung Diseases, Interstitial/mortality , Lung Diseases, Interstitial/therapy , Risk Assessment , Pulmonary Disease, Chronic Obstructive/mortality , Pulmonary Disease, Chronic Obstructive/therapy , Protective Factors , SARS-CoV-2 , COVID-19/mortality , COVID-19/therapy
14.
Epidemiol. serv. saúde ; 32(2): e2022701, 2023. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1430318

ABSTRACT

Objetivo: analisar condições clínicas e características sociodemográficas associadas ao óbito por covid-19 no primeiro ano da pandemia em Recife, Pernambuco, Brasil, 2020. Métodos: estudo transversal, sobre casos de síndrome respiratória aguda grave por covid-19 registrados no Centro de Informações Estratégicas de Vigilância em Saúde de Pernambuco, via sistema eletrônico "Notifique Aqui"; analisou-se a associação do óbito com variáveis sociodemográficas e clínicas; razões de prevalências (RP) com intervalos de confiança de 95% (IC95%) foram calculadas por regressão de Poisson ajustada. Resultados: prevalência do óbito de 28,4% (2.833 casos; IC95% 27,51;29,28); sexo masculino (RP = 1,05; IC95% 1,01;1,08), idade ≥ 60 anos (RP = 0,76; IC95% 0,72;0,79), dispneia (RP = 1,06; IC95% 1,02;1,10), desconforto respiratório (RP = 1,06; IC95% 1,03;1,09), saturação de oxigênio < 95% (RP = 1,08; IC95% 1,04;1,11) e doenças crônicas revelaram-se fatores associados. Conclusão: o óbito por covid-19 foi mais prevalente entre sexo masculino, idosos, pessoas com problemas de saúde preexistentes - grupos prioritários no enfrentamento à pandemia.


Objetivo: analizar las condiciones clínicas y características sociodemográficas asociadas a la muerte por covid-19 en el primer año de la pandemia en la ciudad de Recife. Métodos: estudio transversal con casos de síndrome respiratorio agudo severo por covid-19 registrados en 2020 a través del sistema electrónico "Notifique Aquí" del Centro de Información Estratégica de Vigilancia en Salud de Pernambuco. Se analizó la asociación entre la muerte y variables sociodemográficas y clínicas. Los cocientes de prevalencia (CP) con intervalos de confianza (IC) del 95% se calcularon mediante una regresión de Poisson ajustada. Resultados: la prevalencia de muerte fue del 28,4% (2.833 casos, IC95% 27,51;29,28). Sexo masculino (CP = 1,05; IC95% 1,01;1,08), edad ≥60 años (CP = 0,76; IC95% 0,72;0,79), disnea (CP = 1,06; IC95% 1,02;1,10), dificultad respiratoria (CP = 1,06; IC95% 1,03;1,09) y saturación de oxígeno < 95% (CP = 1,08; IC95% 1,04;1,11) y enfermedades crónicas fueron factores asociados. Conclusión: la muerte por covid-19 fue más prevalente entre hombres, ancianos y personas con problemas de salud preexistentes, grupos prioritarios en el enfrentamiento a la pandemia.


Objective: to analyze the clinical conditions and sociodemographic characteristics associated with covid-19 deaths in the first year of the pandemic in the city of Recife, Pernambuco, Brazil, 2020. Methods: this was a cross-sectional study with covid-19-induced severe acute respiratory syndrome cases recorded in 2020 via the "Notifique Aqui" (Report Here) electronic system of the Pernambuco Center for Strategic Information on Health Surveillance. Association between death and sociodemographic and clinical variables was analyzed. Prevalence ratios (PR) with 95% confidence intervals (95%CI) were calculated using adjusted Poisson regression. Results: the prevalence of death was 28.4% (2,833 cases; 95%CI 27.51;29.28). The associated factors were male sex (PR = 1.05; 95%CI 1.01;1.08), age ≥ 60 years (PR = 0.76; 95%CI 0.72;0.79), dyspnea (PR = 1.06; 95%CI 1.02;1.10), respiratory distress (PR = 1.06; 95%CI 1.03;1.09), oxygen saturation < 95% (PR = 1.08; 95%CI 1.04;1.11) and chronic diseases. Conclusion: covid-19 deaths were more prevalent among male, older adults, and people with pre-existing health problems, these being priority groups for combating the pandemic.


Subject(s)
Humans , Male , Female , Health Information Systems , COVID-19/complications , COVID-19/mortality , COVID-19/epidemiology , Socioeconomic Factors , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Risk Factors , Severe acute respiratory syndrome-related coronavirus
15.
Rev. baiana enferm ; 37: e50696, 2023. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1529685

ABSTRACT

Objetivos: apreender as percepções dos profissionais de saúde que atuam em Unidade de Terapia Intensiva sobre os cuidados paliativos na assistência aos pacientes com Covid-19. Método: estudo descritivo-exploratório, qualitativo, realizado com profissionais que atuavam em Unidade de Terapia Intensiva de um hospital público. A coleta ocorreu em 2021, por meio de entrevistas semiestruturadas. Os dados foram organizados e analisados mediante o software IRAMUTEQ®, considerando o referencial da Análise de Conteúdo. Resultados: participaram 10 profissionais. Dos discursos emergiram três categorias: Ainda falta muito conhecimento: barreira para a implementação dos cuidados paliativos; Cuidado paliativo não é decreto de morte!: percepção ampliada do conceito; Ajuda a manter a dignidade da pessoa: cuidados paliativos no contexto da pandemia da Covid-19. Considerações finais: no contexto da pandemia, os profissionais sentiram insegurança e despreparo para implementação de cuidados paliativos, especialmente em decorrência do conhecimento incipiente, embora o compreendesse como importante ferramenta para manter a dignidade humana.


Objetivos: Comprender las percepciones de los profesionales de salud que actúan en Unidad de Terapia Intensiva sobre los cuidados paliativos en la atención a los pacientes con Covid-19. Método: estudio descriptivo-exploratorio, cualitativo, realizado con profesionales que actuaban en Unidad de Terapia Intensiva de un hospital público. La colecta tuvo lugar en 2021, a través de entrevistas semiestructuradas. Los datos fueron organizados y analizados mediante el software IRAMUTEQ®, considerando el referencial del Análisis de Contenido. Resultados: participaron 10 profesionales. De los discursos surgieron tres categorías: Aún falta mucho conocimiento: barrera para la implementación de los cuidados paliativos; Cuidado paliativo no es decreto de muerte!: percepción ampliada del concepto; Ayuda a mantener la dignidad de la persona: cuidados paliativos en el contexto de la pandemia de Covid-19. Consideraciones finales: en el contexto de la pandemia, los profesionales sintieron inseguridad y falta de preparación para la implementación de cuidados paliativos, especialmente en el marco del conocimiento incipiente, aunque lo comprendieran como una importante herramienta para mantener la dignidad humana.


Objective: to apprehend the perceptions of health professionals working in the Intensive Care Unit on palliative care in the care of patients with Covid-19. Method: descriptive-exploratory study, qualitative, conducted with professionals who worked in an Intensive Care Unit of a public hospital. The collection took place in 2021, through semi-structured interviews. The data were organized and analyzed using the IRAMUTEQ® software, considering the reference of Content Analysis. Results: 10 professionals participated. Three categories emerged from the speeches: There is still a lack of knowledge: barrier to the implementation of palliative care; Palliative care is not a death decree!: expanded perception of the concept; It helps maintain the dignity of the person: palliative care in the context of the Covid-19 pandemic. Final considerations: in the context of the pandemic, professionals felt insecurity and unprepared to implement palliative care, especially due to incipient knowledge, although they understood it as an important tool to maintain human dignity.


Subject(s)
Humans , Male , Female , Patient Care Team , COVID-19/mortality , Qualitative Research
16.
Clin. biomed. res ; 43(1): 9-13, 2023.
Article in English | LILACS | ID: biblio-1435591

ABSTRACT

Introduction: COVID-19 caused 6.2 million deaths in the world. The present study aims to evaluate hospital mortality rates from 2015 to 2022, to compare the pre and during the pandemic period.Methods: The study was carried out in a private hospital in southern Brazil. 174,013 hospital discharges between January 2015 and March 2022 were analyzed. Pearson's chi-squared test was performed to evaluate the mortality rate by year. Differences between mortality rates before and during the pandemic was tested with Student's t-test. P-values < 0.05 for all tests were considered significant.Results: Mortality rates were 2.29% in 2015; 2.37% in 2016; 2.25% in 2017; 2.31% in 2018; 2.46% in 2019; 3.45% in 2020; 3.58% in 2021 and 2.77% in 2022 (p< 0.01). The mortality for 2020 and 2021 was higher than in the other years (3.50% ± 0.14 vs 2.34% ± 0.05; p < 0.01).Conclusion: The mortality rates were significantly higher in the years 2020 and 2021, demonstrating that COVID-19 is a critical health problem.


Subject(s)
Humans , Brazil/epidemiology , COVID-19/mortality , Retrospective Studies , COVID-19
17.
Epidemiol. serv. saúde ; 32(1): e2022303, 2023. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1421410

ABSTRACT

Objetivo analisar a influência da desigualdade socioeconômica na distribuição da covid-19 nos maiores municípios brasileiros (> 100 mil habitantes), controlando, pelo efeito da infraestrutura hospitalar, comorbidades e outras variáveis. Métodos estudo ecológico sobre internações e óbitos por covid-19 em 2020; dados de desfecho obtidos do Ministério da Saúde; a razão de incidência foi estimada via modelo linear generalizado. Resultados identificados 291.073 internações e 139.953 óbitos; encontrou-se maior taxa de mortalidade nos municípios com maior população não branca (IC95% 1,01;1,16) e nos domicílios com mais de duas pessoas por cômodo (IC95% 1,01;1,13); para ambos os desfechos, esgotamento sanitário foi protetivo (internações: IC95% 0,87;0,99 - óbitos: IC95% 0,90;0,99), e população em aglomerados subnormais revelou-se fator de risco (internações: IC95% 1,01;1,16 - óbitos: IC95% 1,09;1,21) com interação, com a proporção de pessoas a receber auxílio emergencial (internações: IC95% 0,88;1,00 - óbitos: IC95% 0,89;0,98). Conclusão condições socioeconômicas afetaram o adoecimento e morte por covid-19 no Brasil.


Objetivo: analizar la influencia de la desigualdad socioeconómica en la distribución de COVID-19 en los mayores municipios brasileños (> 100 mil habitantes), controlando, por la infraestructura hospitalaria, comorbilidades y otras variables. Métodos: estudio ecológico sobre hospitalizaciones y muertes por COVID-19 en 2020; datos del resultado fueran obtenidos del Ministerio de Salud; razón de incidencia estimada a través del modelo lineal generalizado. Resultados: 291.073 hospitalizaciones y 139.953 muertes; mayor tasa de mortalidad en municipios con mayor proporción de población no blanca (IC95% 1,01;1,16) y con más hogares con más de dos personas por habitación (IC95% 1,01;1,13); el alcantarillado sanitario resultó protector (hospitalizaciones: IC95% 0,87;0,99 - muertes: IC95% 0,90;0,99) y la mayor proporción de población en aglomeraciones subnormales fue un factor de riesgo (hospitalizaciones: IC95% 1,01;1,16 - muertes: IC95% 1,09;1,21), interactuando con proporción de personas con asistencia de emergencia (hospitalizaciones IC95% 0,88;1,00, defunciones IC95% 0,89;0,98). Conclusión: las condiciones socioeconómicas afectaron la enfermedad y la muerte por COVID-19.


Objective: to analyze the influence of socioeconomic inequality on COVID-19 istribution in larger Brazilian municipalities, controlling for effect of hospital infrastructure, comorbidities and other variables. Methods: this was an ecological study of COVID-19 hospitalizations and deaths in 2020; outcome data were obtained from the Ministry of Health; incidence ratios were estimated using a generalized linear model. Results: we identified 291,073 hospitalizations and 139,953 deaths; we found higher mortality rates in municipalities with a higher proportion of non-White people (95%CI 1.01;1.16) and with more households with more than two people per room (95%CI 1.01;1.13); presence of sewerage systems was protective for both outcomes (hospitalizations: 95%CI 0.87;0.99 - deaths: 95%CI 0.90;0.99), while a higher proportion of the population in subnormal housing clusters was a risk factor (hospitalizations: 95%CI 1.01;1.16 - deaths: 95%CI 1.09;1.21), with this variable interacting with the proportion of people receiving Emergency Aid (hospitalizations: 95%CI 0.88;1.00 - deaths: 95%CI 0.89;0.98). Conclusion: socioeconomic conditions affected illness and death due to COVID-19 in Brazil.


Subject(s)
Humans , COVID-19/mortality , COVID-19/epidemiology , Hospitalization , Socioeconomic Factors , Brazil/epidemiology , Social Determinants of Health
18.
Rev. méd. hondur ; 90(2): 141-147, jul.-dic. 2022. tab.
Article in Spanish | LILACS, BIMENA | ID: biblio-1418465

ABSTRACT

Según estudios a nivel internacional, los casos fatales de la COVID-19 están relacionados con edad avanzada, sexo masculino y presencia de enfermedades crónicas. Objetivo: Determinar factores de riesgo asociados a mortalidad por COVID-19 en pacientes adultos ingresados en un hospital público de Honduras. Métodos: Estudio tipo casos y controles en pacientes ingresados con diagnóstico de COVID-19; Casos: pacientes con diagnóstico de COVID-19 con condición de egreso fallecido, Controles: pacientes con diagnóstico de COVID-19 con condición de egreso alta médica. Se analizó una muestra de 100 casos y 200 controles. Se realizó análisis de características demográficas, clínicas y laboratoriales, posteriormente se estimaron OR y se construyó un modelo de regresión logística múltiple. Resultados: Se encontró que 57.5% (171/300) tenía 60 años o más y 60.3% (181/300) era del sexo masculino. Los síntomas más frecuentes fueron dificultad respiratoria 94%, fiebre 90.3% y tos 86%. Los factores de riesgo asociados a mortalidad por COVID-19 fueron edad (OR 10.40 IC95% 3.96-27.30), sexo masculino (OR 3.25 IC95% 1.75-6.06), comorbilidades (OR 2.14 IC95% 1.03-4.45), niveles elevados de dímero D (OR 2.28 IC95% 1.20-4.32) y LDH (OR 5.65 IC95% 2.62-12.18). Discusión: Los factores de riesgo asociados a mortalidad por COVID-19 encontrados en este estudio coinciden con los presentados en estudios internacionales. Es necesario identificar los pacientes con estos factores para ofrecer manejos oportunos según su condición clínica...(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Risk Factors , COVID-19/mortality , Post-Acute COVID-19 Syndrome/mortality
19.
Rev. epidemiol. controle infecç ; 12(4): 135-142, out.-dez. 2022. ilus
Article in English | LILACS | ID: biblio-1425921

ABSTRACT

Background and objectives: COVID-19 is a life-threatening disease. Recognizing the main characteristics of the disease and its main complications will help future interventions, care, and management of health services since territorial and population diversities directly influence health outcomes. Our main objective is to describe the clinical characteristics, outcomes, and factors associated with mortality of patients with COVID-19 admitted to the intensive care unit of a public and tertiary hospital. Methods: Cohort study, conducted from March 1 to September 30, 2020. Poisson regression was performed to investigate the variables of hospital treatment as potential risk factors for in-hospital mortality. Results: Of the 283 eligible patients in this study, the hospital mortality rate was of 41.7% (n=118). The most common outcomes were acute respiratory distress syndrome, nosocomial infection, and septic shock. Factors independently associated with increased risk of death were age greater than 51 years old (RR=1.7, 95%CI=1.0-2.8), especially over 70 years old (RR=2.9, 95%CI=1.7-2.8), current smoker (RR=1.8, 95%CI=1.1-2.9), requiring the use of inotrope (RR=1.4, 95%CI=1.0-2.0), and presenting potassium greater than 5.0 mEq/l on admission (RR=1.3, 95%CI=1.0-1.7). Conclusion: Mortality was associated with older age, being a current smoker, inotrope use, and presenting potassium greater than 5.0 on hospital admission.(AU)


Justificativa e objetivos: A COVID-19 é uma doença ameaçadora à vida. Reconhecer as características da doença e suas principais complicações nesta população auxiliará em futuras intervenções, cuidados e gestão dos serviços de saúde, uma vez que a diversidade territorial e populacional influencia diretamente nos resultados de saúde. O objetivo principal do presente estudo é descrever as características clínicas, desfechos e fatores associados à mortalidade de pacientes com COVID-19 internados na unidade de terapia intensiva de um hospital público e terciário. Métodos: Estudo de coorte, realizado de 1º de março a 30 de setembro de 2020. Foi realizada regressão de Poisson para investigar variáveis de apresentação hospitalar como potenciais fatores de risco para mortalidade intra-hospitalar. Resultados: Dos 283 pacientes elegíveis neste estudo, o dado de mortalidade hospitalar foi de 41,7% (n=118). Os desfechos mais comuns foram síndrome do desconforto respiratório agudo, infecção hospitalar e choque séptico. Os fatores independentemente associados ao aumento do risco de morte foram idade superior a 51 anos (RR=1,7, IC 95%=1,0-2,8), principalmente acima de 70 anos (RR=2,9, IC 95%=1,7-2,8), tabagismo atual (RR=1,8, IC 95%=1,1-2,9), necessidade de inotrópico (RR=1,4, IC 95%=1,0-2,0) e potássio maior que 5,0 mEq/l (RR=1,3, IC 95%=1,0- 1.7) na admissão. Conclusão: A mortalidade esteve associada à idade avançada, tabagismo atual, uso de inotrópicos e potássio maior que 5,0 na admissão hospitalar.(AU)


Justificación y objetivos: La COVID-19 es una enfermedad potencialmente mortal. Reconocer las características de la enfermedad y sus principales complicaciones en esta población ayudará a futuras intervenciones, atención y gestión de los servicios de salud, ya que las diversidades territoriales y poblacionales influyen directamente en los resultados de salud. El objetivo principal de este estudio es describir las características clínicas, los resultados y los factores asociados a la mortalidad de los pacientes con COVID-19 ingresados en la unidad de cuidados intensivos de un hospital público y de tercer nivel. Métodos: Estudio de cohorte, realizado del 1 de marzo al 30 de septiembre de 2020. Se realizó regresión de Poisson para investigar variables en la presentación hospitalaria como potenciales factores de riesgo para la mortalidad intrahospitalaria. Resultados: De los 283 pacientes elegibles en este estudio, el 41,7% (n=118) tuvo mortalidad hospitalaria. Los desenlaces más comunes fueron síndrome de dificultad respiratoria aguda, infección nosocomial y shock séptico. Los factores independientemente asociados a mayor riesgo de muerte fueron edad mayor de 51 años (RR=1,7, IC95%=1,0-2,8), especialmente mayores de 70 años (RR=2,9, IC95%=1,7-2,8), tabaquismo actual (RR=1,8, IC95%=1,1-2,9), necesidad de inotrópico (RR=1,4, IC95%=1,0-2,0) y potasio mayor que 5,0 mEq/l (RR=1,3, IC95%=1,0-1,7). Conclusión: La mortalidad estuvo asociada a la edad avanzada, tabaquismo actual, uso de inotrópico y potasio mayor a 5,0 en la admisión hospitalaria.(AU)


Subject(s)
Humans , COVID-19/complications , COVID-19/mortality , Health Profile , Risk Factors , Hospital Mortality , Intensive Care Units
20.
Article in Portuguese | LILACS | ID: biblio-1401458

ABSTRACT

Objetivo: Descrever o perfil de óbitos por COVID-19 no município de Rio Grande, Rio Grande do Sul, Brasil. Metodologia: Trata-se de um estudo transversal, descritivo, com dados oriundos do banco de óbitos da Vigilância Epidemiológica, registrados no período de março a dezembro de 2020. Resultados: Dos 194 óbitos, a maioria era do sexo masculino (63,4%), com 60 anos ou mais (82,5%), de cor da pele branca (82,5%), residentes na região central histórica do município (11,3%). Quanto à ocupação, a maior ocorrência de óbitos foi entre os aposentados (69,5%), seguido por comerciante ou autônomo (17,7%). Com relação às morbidades, 38,7% tinha cardiopatias, 29,4% hipertensão arterial sistêmica, 28,0% diabetes mellitus e praticamente a metade dos indivíduos tinha multimorbidade (49,0%). Conclusões: Com a identificação do perfil de óbitos por COVID-19 no município de Rio Grande no período de março a dezembro de 2020, esses dados podem contribuir para auxiliar os gestores no planejamento de ações estratégicas e educativas de prevenção e combate à COVID-19, principalmente no direcionamento de grupos prioritários nas campanhas de vacinação (AU)


Objective: Describe the COVID-19 death profile in the city of Rio Grande, Rio Grande do Sul, Brazil. Methods: This is a cross-sectional descriptive study using data from the Epidemiological Surveillance service deaths database of deaths notified from March to December 2020. Results: Of the 194 deaths, most were male (63.4%), aged 60 years or more (82.5%), of white skin color (82.5%), and living in the central historic district of the city (11.3%). With regard to occupation, the highest occurrence of deaths was among retirees (69.5%), followed by tradesmen or the self-employed (17.7%). Regarding morbidities, 38.7% had heart disease, 29.4% hypertension, 28.0% diabetes mellitus, and practically half of the individuals had multiple morbidities (49.0%). Conclusions: We identified the profile of COVID-19 deaths in the city of Rio Grande in the period from March to December 2020. These data can help health service managers to plan strategic and educational actions to prevent and combat COVID-19, mainly by targeting priority groups in vaccination campaigns


Subject(s)
Humans , Cross-Sectional Studies , Immunization Programs , Epidemiological Monitoring , Multimorbidity , COVID-19/mortality , COVID-19/epidemiology
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