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Rev. ADM ; 79(3): 136-145, mayo-jun. 2022. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1377862


Durante la pandemia por COVID-19, la presencia de un incremento de fracturas y/o fisuras verticales ha sido reportada por Cirujanos Dentistas en diferentes países y foros, Objetivo: Determinar por medio de un análisis si existe una relación con este aumento de casos y la evolu- ción de la pandemia. Material y método: Se recopilaron los casos de fracturas verticales no restaurables durante el periodo de mayor índice de casos de contagio y defunciones por COVID-19 en la Ciudad de Chihuahua, México. Resultados: Durante el primer pico de casos y defunciones causadas por la pandemia, se incrementó el número de casos de fracturas verticales no tratables. Conclusiones: Existió una relación entre la evolución de la pandemia con la aparición de casos de fracturas dentales verticales no restaurables (AU)

During the COVID-19 pandemic, the presence of an increase in fractures and/or vertical fissures has been reported by Dental Surgeons in different countries and forums. Objective: To determine through an analysis, if there is a relationship with this increase in cases and the evolution of the pandemic. Material and methods: The cases of non-restorable vertical fractures were collected during the period of highest rate of cases of contagion and deaths due to COVID-19 in the City of Chihuahua, Mexico. Results: during the 1st peak of cases and deaths caused by the pandemic, the number of cases of untreatable vertical fractures increased. Conclusions: There was a relationship between the evolution of the pandemic and the appearance of cases of non-restorable vertical dental fractures (AU)

Humans , Male , Female , Adult , Middle Aged , Tooth Fractures/epidemiology , COVID-19 , Mexico/epidemiology , Root Canal Therapy , Tooth Root/injuries , Dental Fissures/epidemiology , Age and Sex Distribution , COVID-19/mortality , COVID-19/transmission
Medicina (Ribeirao Preto, Online) ; 55(1)maio 2022. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1402669


Introdução: apesar de ser o país de maior média de idade no mundo, o Japão tem se destacado no combate à pandemia da COVID-19 (do inglês Coronavirus Disease 2019) ao apresentar reduzidas taxas de contaminação pelo vírus e de mortalidade. Objetivo: discutir acerca das estratégias em saúde adotadas pelo Japão diante da pandemia da doença da COVID-19, bem como avaliar os dados sobre contaminação e mortalidade japoneses em comparação com os outros quatro países com maior média de idade do mundo (Itália, Alemanha, Portugal e Espanha) e o Brasil. Metodologia: para avaliação das estratégias em saúde japonesas foi realizada busca nas bases de dados: PubMed, Cochrane e Scielo, utilizando-se combinação dos termos "Japão", "covid", "coronavirus" e "sistemas de saúde", nos idiomas Inglês, Espanhol e Português. Os dados de infecção da COVID-19 foram extraídos do site Our World in Data, correspondendo ao período de 25 de janeiro de 2020 a 30 de julho de 2020. Resultados: dentre as medidas adotadas pelo país no enfrentamento à pandemia, destacam-se o diagnóstico e resposta precoces à infecção, o rastreamento de contatos, o diagnóstico precoce e disponibilidade de cuidados intensivos para pacientes graves e estímulo a medidas comportamentais de distanciamento. Dentre os países analisados, o Japão apresenta as menores taxas de contaminação e mortalidade em termos absolutos pela COVID-19. Conclusões: medidas de distanciamento social, diagnóstico e tratamento precoces parecem ter contribuído para o sucesso no combate à COVID-19 no Japão. No período estudado, em milhão de habitantes, o Japão teve 6,13 casos de Covid, enquanto o Brasil apresentou 218,26 casos. Já no número de mortes confirmadas pela doença, o primeiro teve uma taxa de 0,23 enquanto o segundo de 5,16 casos por milhão de habitantes. É possível, a partir do conhecimento dessas medidas, buscar mecanismos semelhantes ao traçar políticas de saúde no enfrentamento de pandemias em outros países (AU)

Introduction: despite being the country with the highest average age globally, Japan has stood out in the fight against the COVID-19 (Coronavirus Disease 2019) pandemic by presenting low contamination rates by the virus and mortality. Objective: we aim to discuss the health strategies adopted by Japan in the face of the COVID-19 disease pandemic, as well as to evaluate data on Japanese contamination and mortality compared to the other four countries with the highest average age in the world (Italy, Germany, Portugal and Spain) and Brazil. Methodology: the search was carried out to evaluate Japanese health strategies by using the following databases: PubMed, Cochrane, and Scielo using a combination of the terms "Japan", "covid", "coronavirus" and "health systems" in English, Spanish and Portuguese. The COVID-19 infection data was extracted from the Our World in Data website, from January 25, 2020, to July 30, 2020. Results: Among the measures adopted by the country to face the pandemic, the early diagnosis and response to infection, contact tracing, early diagnosis and availability of intensive care for critically ill patients, and encouraging behavioral distancing measures stand out. Among the countries analyzed, Japan has the lowest rates of contamination and mortality in absolute terms by COVID-19. Conclusions: social distancing measures, early diagnosis, and treatment seem to have contributed to the success in combating COVID-19 in Japan. In the studied period, in a million inhabitants, Japan had 6.13 cases of covid while Brazil had 218.26 cases. As for the number of deaths confirmed by the disease, the first had a rate of 0.23 while the second had 5.16 cases per million inhabitants. Based on the knowledge of these measures, it is possible to seek similar mechanisms when designing health policies to face pandemics in other countries (AU)

Humans , Male , Female , Adult , Middle Aged , Coronavirus/pathogenicity , National Health Systems , COVID-19/mortality , COVID-19/transmission , Japan
Hematol., Transfus. Cell Ther. (Impr.) ; 44(2): 218-224, Apr.-June 2022. tab
Article in English | LILACS | ID: biblio-1385064


Abstract Introduction The novel SARS-CoV-2 infection has been spreading around the world since January 2020 causing the Corona Virus Disease 2019. Leukopenia, lymphopenia and hypercoagulability with elevated D- Dimers have been described in COVID-19 patients to date. This study aimed to clarify if some blood parameters can be used as biomarkers to facilitate diagnosis and establish prognosis. Methods: We selected patients who had tested positive for SARS-CoV-2 and had had a hemogram performed between the March 15 and April 15, 2020. Socio-demographic and analytical data were obtained from 274 patients at admission in two Portuguese public hospitals. We then analyzed the hemogram parameters at admission in the intensive care and collected data on patient survival during the SARS-CoV-2 disease follow-up. The data were analyzed using appropriate statistical tests. Results: Patients requiring the intensive care unit (ICU) present an increase in leukocytes and neutrophils (+3.1 × 109/L and +6.4 × 109/L, respectively), a lymphocyte decrease and a platelet rise (-1.6 × 109/L and +60.8 × 109/L, respectively). The erythrocytes, hemoglobin and median globular volume tend to decrease (-0.5 × 1012, - 1.2 g/dL; -3 fL, respectively). The lactic acid dehydrogenase (LDH) at admission was significantly higher (+58.1 U/L). The age, sex, platelets, lymphocyte count neutrophil counts, neutrophil/lymphocyte ratio, erythrocytes and cell hemoglobin concentration mean (CHCM) are independently associated with mortality (odds ratio (OR) = 0.046, p < 0.001; OR = 0.2364, p= 0.045; OR = 9.106, p= 0.001; OR = 0.194, p= 0.033; OR = 0.062, p= 0.003; OR = 0.098, p= 0.002; OR = 9.021, p < 0.001; OR = 7.016, p= 0.007, respectively). Conclusion The hematological data at admission in the health care system can predict the mortality of the SARS-CoV-2 infection and we recommend its use in the clinical decisions and patient prognosis evaluation.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , SARS-CoV-2 , COVID-19/mortality , Hematologic Diseases , Reference Standards , Blood Cell Count , Biomarkers , Mortality , Thrombophilia , Intensive Care Units , Leukopenia , Lymphopenia
Hematol., Transfus. Cell Ther. (Impr.) ; 44(2): 235-245, Apr.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1385065


Abstract Introduction The evolving COVID-19 pandemic became a hallmark in human history, not only by changing lifestyles, but also by enriching scientific knowledge on viral infection and its consequences. Objective Although the management of cardiorespiratory changes is pivotal to a favorable prognosis during severe clinical findings, dysregulation of other systems caused by SARS-CoV-2 infection may imbalance erythrocyte dynamics, such as a bidirectional positive feedback loop pathophysiology. Method and Results Recent evidence shows that SARS-CoV-2 is capable of affecting the genetics and dynamics of erythrocytes and this coexists with a non-homeostatic function of cardiovascular, respiratory and renal systems during COVID-19. In hypothesis, SARS-CoV-2-induced systematical alterations of erythrocytes dynamics would constitute a setpoint for COVID-19-related multiple organ failure syndrome and death. Conclusion The present review covers the most frequent erythrocyte-related non-homeostatic findings during COVID-19 capable of providing mechanistic clues of SARS-CoV-2-induced infection and inspiring therapeutic-oriented scientific evidence.

Erythrocytes , SARS-CoV-2 , COVID-19/mortality , Prognosis , Hemoglobins , Hematologic Diseases
Prensa méd. argent ; 108(2): 55-60, 20220000. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1368358


El certificado médico de defunción (CMD) es la fuente de las estadísticas de causas de muerte en nuestro país. La falta de precisión de los datos que allí se registran afecta al análisis de las estadísticas de mortalidad y al diseño de políticas sanitarias basadas en dicho examen. La calidad de la información sobre causas de muerte se verá más o menos comprometida en la medida que el médico realice el registro de las causas de muerte acorde a los estándares establecidos por las autoridades sanitarias. La pandemia por COVID 19 ha resaltado la importancia de generar estadísticas confiables en salud, al mismo tiempo que la elaboración de esa información se ha visto afectada por diversos motivos. Se analizó la calidad del registro de causas de fallecimiento de pacientes con COVID 19 en el Hospital de Clínicas "José de San Martín". Se revisaron 488 certificados médicos de defunción (CMD) correspondientes a todos los fallecidos en el Hospital de Clínicas entre 13/04/2020 al 10/09/2020 (n: 373) y desde el 07/05/2021 al 08/06/2021 (n: 115). De todos ellos, 127 CMD informaban en al menos una de sus causas a la COVID 19 (códigos U.7 y siguientes del CIE 10). Hubo un 74,02% (n: 94) de causas de muerte "poco útiles" entre las causas inmediatas, 18,9% (n:24) entre las mediatas y 0% (n:0) en las originales. c) Se registró en forma completa el intervalo entre la enfermedad y la muerte en el 4,72% (n:6); y se registró la Causa Contribuyente (parte 2 del CMD) en un 11,02% (n: 14). La calidad de los registros de mortalidad por COVID 19 está comprometida. Se observó una alta proporción de "causas poco útiles" como registro en las causas de fallecimiento, y un déficit en el llenado del intervalo entre la enfermedad y la muerte, y en la causa contribuyente del fallecimiento. Debemos trabajar en todos los niveles para contribuir al mejoramiento de la certificación de las defunciones y por ende, a la obtención de estadísticas de mortalidad y de causas de muerte más precisas, que apoyen la evaluación de políticas públicas y la toma de decisiones acertadas en pro de la salud de la población.

The medical death certificate (CMD) is the source of the statistics of causes of death in our country. The lack of precision of the data recorded there affects the analysis of mortality statistics and the design of health policies based on said examination. The quality of the information on causes of death will be more or less compromised to the extent that the physician registers the causes of death in accordance with the standards established by the health authorities. The COVID 19 pandemic has highlighted the importance of generating reliable health statistics, at the same time that the preparation of this information has been affected for various reasons. The quality of the registry of causes of death of patients with COVID 19 at the Hospital de Clínicas "José de San Martín" was analyzed. We reviewed 488 medical death certificates (CMD) corresponding to all those who died at the Hospital de Clínicas between 04/13/2020 and 09/10/2020 (n: 373) and from 05/07/2021 to 06/08/ 2021 (no.: 115). Of all of them, 127 CMDs reported COVID 19 in at least one of their causes (ICD 10 codes U.7 and following). There were 74.02% (n: 94) of "not very useful" causes of death among the immediate causes, 18.9% (n: 24) among the mediate ones, and 0% (n: 0) in the original ones. c) The interval between illness and death was fully recorded in 4.72% (n:6); and the Contributing Cause (part 2 of the CMD) was registered in 11.02% (n: 14). The quality of COVID 19 mortality records is compromised. A high proportion of "unhelpful causes" was observed as a registry in the causes of death, and a deficit in filling the interval between illness and death, and in the contributing cause of death. We must work at all levels to contribute to improving the certification of deaths and, therefore, to obtaining more accurate mortality statistics and causes of death, which support the evaluation of public policies and the making of sound decisions in favor of the population health.

Death Certificates , Epidemiology, Descriptive , Cross-Sectional Studies/statistics & numerical data , Cause of Death , Evaluation Studies as Topic , Data Accuracy , COVID-19/mortality
Actual. SIDA. infectol ; 30(108): 42-58, 20220000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1363401


A la fecha, excepto los glucocorticoides, ningún otro tratamiento farmacológico ha demostrado disminución de la mortalidad en pacientes con COVID-19 grave-crítico. Con el objetivo de discutir su utilidad en la terapéutica, se realizó una revisión y lectura crítica de los estudios publicados más significativos sobre el uso de tocilizumab.Se llevó adelante una búsqueda en las principales bases de datos bibliográficas priorizando la inclusión de revisiones sistemáticas y ensayos clínicos aleatorizados controlados (ERC) que analizaran el efecto del tocilizumab en COVID-19 en diferentes puntos de valoración.Se incluyeron 5 ERC y 4 metaanálisis en la evaluación, todos ellos incluyeron pacientes con COVID-19 confirmado y mayoritariamente graves-críticos. El punto de valoración principal (PVP) fue la mortalidad a los 28 días y como resultado secundario de relevancia, la progresión a ventilación mecánica invasiva (VMI). Se analizó, además, la seguridad de la intervención, fundamentalmente a nivel de la ocurrencia de infecciones secundarias.Del análisis surge que la mayor posibilidad de beneficio parece estar circunscripta a pacientes con enfermedad grave-crítica, que reciben corticoides, con marcadores de inflamación elevados (PCR >10 mg/dL) y enfermedad rápidamente progresiva. Existe alto grado de certeza respecto del impacto del tocilizumab en evitar la progresión a VMI, con una pequeña magnitud del efecto y moderado grado de certeza respecto de su impacto en la mortalidad; además de que resultó una medicación segura

Up until now, other than corticosteroids, no other pharmacological treatment has shown a decrease in mortality rate in patients with severe-critical COVID-19. In order to discuss its place in therapy, a review and critical reading of the most significant published studies on the use of tocilizumab was carried out.Search was done in the main bibliographic databases, prioritizing the inclusion of systematic reviews and randomized controlled clinical trials (RCTs); that analyzed the effect of tocilizumab on COVID-19 at different endpoints.5 RCTs and 4 meta-analysis were considered in the evaluation, all of them including patients with confirmed COVID-19 and predominantly severe-critical illness. The primary endpoint was 28-day all-cause mortality and, as a secondary outcome of relevance, progression to invasive mechanical ventilation. The safety of the intervention was also analyzed, mainly the occurrence of secondary infections.From our analysis it appears that the greatest possibility of benefit seems to be limited to patients with severe-critical illness, who receive corticosteroids, with high markers of inflammation values (CRP> 10 mg/dL) and rapidly progressive disease. There is high certainty regarding the impact of tocilizumab in preventing progression to IMV, with a small effect size and moderate certainty regarding its impact on mortality. Moreover, it was a well-tolerated and safe medication

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , COVID-19/drug therapy , Randomized Controlled Trials as Topic , Meta-Analysis as Topic , Treatment Outcome , COVID-19/mortality
Arq. Asma, Alerg. Imunol ; 6(1): 1-3, jan.mar.2022. ilus
Article in English, Portuguese | LILACS | ID: biblio-1400083
Fisioter. Bras ; 23(1): 128-151, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358609


Introdução: Envelhecer resulta em transformações biológicas que afetam os indivíduos de maneira heterogênea. A maioria dos sistemas orgânicos experimenta redução em suas funções motoras e cognitivas, interferindo na capacidade de adaptação frente a agentes estressores. Na pneumonia pelo SARS-CoV2, evidenciaram-se implicações da função pulmonar em idosos com doenças pulmonares crônicas. Objetivo: Investigar as evidências científicas sobre implicações clínicas da COVID-19 em indivíduos idosos com doença pulmonar crônica não transmissível. Métodos: revisão integrativa realizada em novembro de 2020 nas bases de dados CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, Scopus, Medline/Pubmed (via National Library of Medicine) e Web of Science, utilizando-se os descritores "COVID-19", "SARS-CoV2 infection", "aged", "chronic pulmonar obstructive disease", "non-communicable diseases" e operadores booleanos AND e OR. Foram incluídos textos científicos originais, a exemplo de artigos disponibilizados na íntegra, sobre a COVID-19 em idosos com Doenças Respiratórias Crônicas Não Transmissíveis. Resultados: Idosos com comorbidades estão propensos a complicações durante a infecção por COVID-19, com altas taxas de mortalidade e alterações tomográficas atípicas. Conclusão: A forma grave da COVID-19 e a elevada mortalidade em idosos podem ser atribuídas à alta comorbidade, prevalência de demência e síndromes geriátricas. (AU)

Humans , Aged , COVID-19/mortality , Lung Diseases , Comorbidity , Chronic Disease
Int. j. cardiovasc. sci. (Impr.) ; 35(1): 58-64, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1356321


Abstract Background In Brazil the factors involved in the risk of death in patients with COVID-19 have not been well established. Objective To analyze whether elevations of high-sensitivity troponin I (hTnI) levels influence the mortality of patients with COVID-19. Methods Clinical and laboratory characteristics of hospitalized patients with COVID-19 were collected upon hospital admission. Univariate and binary logistic regression analyzes were performed to assess the factors that influence mortality. P-value<0.05 was considered significant. Results This study analyzed192 patients who received hospital admission between March 16 and June 2, 2020 and who were discharged or died by July 2, 2020. The mean age was 70±15 years, 80 (41.7%) of whom were women. In comparison to those who were discharged, the 54 (28.1%) who died were older (79±12 vs 66±15years; P=0.004), and with a higher Charlson´s index (5±2 vs 3±2; P=0.027). More patients, aged≥60years (P <0.0001), Charlson´s index>1 (P=0.004), lung injury>50% in chest computed tomography (P=0.011), with previous coronary artery disease (P=0.037), hypertension (P=0.033), stroke (P=0.008), heart failure (P=0.002), lymphocytopenia (P=0.024), high D-dimer (P=0.024), high INR (P=0.003), hTnI (P<0.0001), high creatinine (P<0.0001), invasive mechanical ventilation (P<0.0001), renal replacement therapy (P<0.0001), vasoactive amine (P<0.0001), and transfer to the ICU (P=0.001), died when compared to those who were discharged. In logistic regression analysis, elevated hTnI levels (OR=9.504; 95% CI=1.281-70.528; P=0.028) upon admission, and the need for mechanical ventilation during hospitalization (OR=46.691; 95% CI=2.360-923.706; P=0.012) increased the chance of in-hospital mortality. Conclusion This study suggests that in COVID-19 disease, myocardial injury upon hospital admission is a harbinger of poor prognosis.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Troponin I/blood , COVID-19/mortality , Myocarditis/complications , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/etiology , Retrospective Studies , Cohort Studies , COVID-19/complications
Online braz. j. nurs. (Online) ; 21(supl.2): e20226553, 21 janeiro 2022. ilus, tab
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1391220


OBJETIVO: analisar, sob a ótica interseccional, os atravessamentos do quesito raça/cor na morbimortalidade de gestantes pela COVID-19 no Brasil. MÉTODO: estudo ecológico, documental, desenvolvido a partir dos boletins epidemiológicos de acompanhamento do novo coronavírus no Brasil. Os dados foram coletados nos meses de março e abril de 2021 e analisados através de estatística descritiva, mediada pelo modelo teórico-metodológico da interseccionalidade. RESULTADOS: gestantes negras apresentaram taxa média de prevalência de 65,18% das internações e 70,85% dos óbitos por COVID-19 no ano de 2020. Por outro lado, a taxa média de prevalência de internações e óbitos entre gestantes brancas foi de 32,32% e 27,23%, respectivamente. CONCLUSÃO: A maior dificuldade no acesso ao pré-natal, a alta taxa de prevalência de comorbidades, as precárias condições de trabalho e dificuldade de afastamento durante a pandemia, o racismo institucional e a necropolítica adotada pelo Estado Brasileiro são possíveis explicações para essa expressiva situação de vulnerabilidade.

OBJECTIVE: to analyze racial biases in the context of morbidity and mortality due to COVID-19 of Brazilian pregnant women from an intersectional perspective. METHOD: an ecological, documental study using epidemiological bulletins intended to monitor the novel coronavirus in Brazil. Data were collected in March and April 2021 and analyzed using descriptive statistics mediated by the intersectional theory-based methodology. RESULTS: Afro-descendant pregnant women presented an average prevalence rate of 65.18% hospitalizations and 70.85% deaths due to COVID-19 in 2020. On the other hand, the average prevalence rate of hospitalizations and deaths among Caucasian pregnant women was 32.32% and 27.23%, respectively. CONCLUSION: A greater difficulty to access prenatal care, a high prevalence rate of comorbidities, poor working conditions and impossibility to leave work during the pandemic, institutional racism, and necropolitics adopted by the Brazilian government are potential explanations for the vulnerable context faced by this population.

OBJETIVO: analizar bajo la óptica de la interseccionalidad, los vínculos de la cuestión raza/color en la morbimortalidad de gestantes por el Covid-19, en Brasil. MÉTODO: estudio ecológico y documental, desarrollado a partir de los boletines epidemiológicos de acompañamiento del nuevo coronavirus, en Brasil. Los datos fueron recogidos en los meses de marzo y abril de 2021 y analizados a través de la estadística descriptiva, mediada por el modelo teórico metodológico de la interseccionalidad. RESULTADOS: las gestantes negras presentaron tasa media de prevalencia de 65,18% de las internaciones y 70,85% de las muertes, por COVID-19, en el año de 2020. Por otro lado, la tasa media de prevalencia de internaciones y muertes entre gestantes blancas fue de 32,32% y 27,23%, respectivamente. CONCLUSIÓN: la mayor dificultad en acceder al prenatal, la alta tasa de prevalencia de comorbilidades, las precarias condiciones de trabajo y dificultad del distanciamiento social (durante la pandemia), el racismo institucional y la política de muerte adoptada por el Estado Brasileño, son posibles explicaciones para esa expresiva situación de vulnerabilidad.

Humans , Female , Pregnancy , Indicators of Morbidity and Mortality , Severe Acute Respiratory Syndrome/mortality , Pregnant Women , Social Determinants of Health , COVID-19/mortality , Intersectional Framework , Brazil , Epidemiology, Descriptive , Blacks , Ecological Studies
Rev. Assoc. Med. Bras. (1992) ; 68(1): 82-86, Jan. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360700


SUMMARY OBJECTIVE: The aim of this study was to evaluate and compare C-reactive protein and C-reactive protein-to-albumin ratio performances in predicting mortality of geriatric patients who visited the emergency department. METHODS: The data of patients with COVID-19 and aged 65 years and above, who visited emergency department during the study period, were retrospectively analyzed. The data were obtained from an electronic-based hospital information system. The area under the receiver operating characteristic curve and the area under the curve were used to assess each cutoff value discriminatory for predicting mortality. RESULTS: The mean age of the population included in this study was 76 (71-82) years, while 52.7% were males. The sensitivity, specificity, and area under the curve values for C-reactive protein in terms of mortality were calculated as 71.01, 52.34, and 0.635%, respectively, while the sensitivity, specificity, and area under the curve values for C-reactive protein-to-albumin ratio were calculated as 75.74, 47.66, and 0.645%, respectively (p<0.001). In the pairwise comparison for the receiver operating characteristic curves of C-reactive protein and C-reactive protein-to-albumin ratio, no statistically significant difference was found. CONCLUSIONS: Geriatric patients are the "most vulnerable" patient group against the COVID-19. In this study, both C-reactive protein and C-reactive protein-to-albumin ratio were found to be successful in predicting mortality for geriatric COVID-19 patients.

Humans , Male , Female , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Albumins/analysis , COVID-19/diagnosis , COVID-19/mortality , Prognosis , Retrospective Studies , ROC Curve , SARS-CoV-2
Epidemiol. serv. saúde ; 31(1): e2021869, 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1375387


Objetivo: Analisar a associação entre diabetes mellitus e óbito hospitalar por COVID-19 no Brasil, de fevereiro a agosto de 2020. Métodos: Estudo transversal, sobre casos notificados como síndrome gripal no Sistema de Informação de Vigilância da Gripe, positivos para COVID-19 e hospitalizados. A magnitude da associação do diabetes com o óbito foi estimada por regressão de Poisson com variância robusta. Resultados: Foram analisados dados de 397.600 casos hospitalizados, dos quais 32,0% (n = 127.231) evoluíram a óbito. A prevalência de óbito entre pessoas com diabetes foi de 40,8% (RP = 1,41; IC95% 1,39;1,42). Após ajustes por variáveis sociodemográficas e comorbidades, observou-se que o óbito foi 1,15 vez mais frequente entre aqueles com diabetes (IC95% 1,14;1,16). Conclusão: 3 a cada 20 óbitos por COVID-19 ocorreram em indivíduos com diabetes mellitus, destacando-se a suscetibilidade dessa população e a necessidade de controle dessa doença crônica.

Objetivo: Analizar la asociación entre la diabetes mellitus y la muerte hospitalaria por COVID-19 en Brasil, de febrero a agosto de 2020. Métodos: Estudio transversal con casos notificados como síndrome gripal en el Sistema de Información de Vigilancia de Influenza, positivos para COVID-19 y hospitalizados. La magnitud de la asociación entre diabetes y muerte se estimó mediante la regresión de Poisson con varianza robusta. Resultados: Se analizaron datos de 397.600 casos hospitalizados, de los cuales 32,0% (n = 127.231) fallecieron. La prevalencia de muerte entre las personas con diabetes fue de 40,8% (RP = 1,41; IC95% 1,39;1,42). Después de ajustar por variables sociodemográficasy comorbilidades, se observó que la muerte era 1,15 vez más frecuente entre los diabéticos (IC95% 1,14;1,15). Conclusión: 3 de cada 20 muertes por COVID-19 ocurrieron en individuos con diabetes mellitus, destacando la susceptibilidad de esta población y la necesidad de control de esta enfermedad crónica.

Objective: To analyze the association between diabetes mellitus and hospital deaths due to Covid-19 in Brazil, from February to August 2020. Methods: This was a cross-sectional study on hospitalized flu-like syndrome cases, with a positive test result for COVID-19, reported on the Influenza Epidemiological Surveillance Information System. Poisson regression with robust variance was used to estimate the magnitude of the association between diabetes and deaths. Results: Data from 397,600 hospitalized cases were analyzed, of which 32.0% (n = 127,231) died. The prevalence of death among people with diabetes was 40.8% (PR = 1.41; 95%CI 1.39;1.42). After adjustments for the variables sociodemographic and comorbidities, it could be seen that those with diabetes (95%CI 1.14;1.16) were 1.15 time more likely to die. Conclusion: 3 out of every 20 deaths due to COVID-19 occurred among individuals with diabetes mellitus, highlighting this population susceptibility and the need to control this chronic disease.

Humans , Diabetes Mellitus/epidemiology , COVID-19/mortality , COVID-19/epidemiology , Hospitalization/statistics & numerical data , Brazil/epidemiology , Comorbidity , Cross-Sectional Studies , Risk Factors , Diabetes Mellitus/mortality
Rev. bras. estud. popul ; 39: e0182, 2022. tab
Article in Portuguese | LILACS | ID: biblio-1357049


A presente nota de pesquisa estima o impacto das mortes por Covid-19 sobre a esperança de vida no Brasil e regiões para os primeiros seis meses de 2020. Com base nos dados do Datasus e nas tábuas de vida com decremento simples, estimou-se que as mortes por Covid-19 ocorridas até 18 de agosto de 2020 tiveram impacto estatisticamente negativo na esperança de vida ao nascer, tanto masculina (-1,05 ano) quanto feminina (-0,85 ano). Em termos regionais, a maior perda em anos de vida é estimada no Norte (-1,65 ano para homens e -1,48 ano para mulheres), enquanto o Sul foi a região com menor impacto (-0,5 ano para homens e -0,36 para mulheres). Os resultados do modelo logístico para o país apontam que a mortalidade por Covid-19 tende a ser maior entre a população com mais de 65 anos, homens, pretos e de baixa instrução. As comorbidades aumentam a chance de desfecho morte, especialmente doença hepática e renal crônica. Tais análises foram ainda desagregadas por grandes regiões brasileiras.

This research note estimates the impact of deaths by Covid-19 on life expectancy in Brazil and the Regions for the first six months of 2020. Based on data from Datasus and the decreasing life tables, it was estimated that deaths by Covid-19 that occurred until August 18, 2020 had a statistically negative impact on life expectancy at birth, both male (-1.05 years) and female (-0.85 years). In regional terms, the greatest loss in years of life is estimated in the North (-1.65 years for men and -1.48 years for women), while in the South it was -0.5 year for men and -0.36 for women. The results of the logistic model for the country show that Covid-19 mortality tends to be higher among males, blacks, people with low education level and people over 65 years old. Comorbidities increase the chance of death, especially liver disease and chronic kidney disease. Such analyzes were further disaggregated by large Brazilian regions.

Esta nota de investigación estima el impacto de las muertes por Covid-19 en la esperanza de vida en Brasil y sus regiones durante los primeros seis meses de 2020. Con base en los datos de Datasus y de las tablas de vida decrecientes, se estimó que las muertes por Covid-19 que ocurrieron hasta el 18 de agosto de 2020 tuvieron un impacto estadísticamente negativo en la esperanza de vida al nacer, tanto en hombres (−1,05 años) como en mujeres (−0,85 año). En términos regionales, la mayor pérdida en años de vida se estima en el Norte (−1,65 año para los hombres y −1,48 años para las mujeres), mientras que en el Sur fue de −0,5 años para los hombres y −0,36 para las mujeres. Los resultados del modelo logístico para el país muestran que la mortalidad por Covid-19 tiende a ser mayor entre la población mayor de 65 años, hombres, afrobrasileros y de bajo nivel educativo. Las comorbilidades aumentan la probabilidad de muerte, especialmente la enfermedad hepática y la enfermedad renal crónica. Dichos análisis se desglosaron aun más por grandes regiones brasileñas.

Humans , Socioeconomic Factors , Brazil , Mortality , Life Tables , COVID-19/mortality , Data Interpretation, Statistical , Life Expectancy , Pandemics
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1356215


RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.

RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.

ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.

Humans , Male , Female , Adult , Middle Aged , Aged , Health Profile , COVID-19/mortality , Antiviral Agents/therapeutic use , Patients' Rooms , Brazil , Comorbidity , Retrospective Studies , Risk Factors , Azithromycin/therapeutic use , Cough , Dyspnea , Renal Insufficiency/complications , Fever , Interactive Ventilatory Support , Myalgia , COVID-19/therapy , Inpatients/statistics & numerical data , Intensive Care Units , Length of Stay/statistics & numerical data , Hypoxia/complications , Anticoagulants/therapeutic use
Bol. malariol. salud ambient ; 62(2): 241-250, 2022. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1379579


Establecer la validez diagnóstica de la escala CALL como predictor de mortalidad en pacientes con COVID-19 severo en Unidad de Cuidados Intensivos del Hospital Regional Docente de Trujillo desde abril del 2020 hasta julio del 2021. Material y métodos: Se llevó a cabo un estudio analítico, retrospectivo, en el cual se incluyeron a 177 pacientes con COVID-19 severo internados en Unidad de Cuidados Intensivos del Hospital Regional Docente de Trujillo, según criterios de selección, se calculó la escala CALL para cada uno y se asoció con la mortalidad encontrada; aplicándose la prueba estadística chi cuadrado; posteriormente se realizó un análisis de regresión multivariante para identificar los factores de riesgo asociados a la mortalidad. A su vez se utilizó el AUROC (área bajo la curva ROC) para establecer el rendimiento predictivo de la escala CALL. Resultados: De una muestra de 177 pacientes, al analizar la información mediante la curva ROC, se obtuvo un valor de corte 6 puntos para la escala CALL, con un área bajo la curva (AUC) de 0.612 (p=0,014); sensibilidad, especificidad, valor predictivo positivo y negativo de 86%, 29%, 60% y 62% respectivamente. No se encontraron diferencias significativas estadísticamente en cuanto a sexo, edad, shock séptico, SOFA, índice de comorbilidad de Charlson, necesidad de TRR ni compliance estática. En cambio, se evidenció asociación con la PaO2/FiO2(AU)

To establish the diagnostic validity of the CALL score as a predictor of mortality in patients with severe COVID-19 in the Intensive Care Unit of the Trujillo Regional Teaching Hospital from April 2020 to July 2021.Material and methods: An analytical, retrospective study was carried out, in which 177 patients with severe COVID-19 admitted to the Intensive Care Unit of the Regional Teaching Hospital of Trujillo were included, according to selection criteria, the CALL score was calculated for each one and was associated with the mortality found; applying the statistical chi 2 test; Subsequently, a multivariate regression analysis was performed to identify risk factors associated with mortality. In turn, the AUROC (area under the ROC curve) was used to establish the predictive performance of the CALL score. Results: From a sample of 177 patients, when analyzing the information using the ROC curve, a cut-off value of 6 points was obtained for the CALL score, with an area under the curve (AUC) of 0.612 (p=0.014); sensitivity, specificity, positive and negative predictive value of 86%, 29%, 60% and 62% respectively. No statistically significant differences were found in terms of sex, age, septic shock, SOFA, Charlson comorbidity index, need for renal replacement therapy (RRT) or static compliance. On the other hand, an association with PaO2 / FiO2 was evidenced(AU)

Humans , Male , Female , Adult , Middle Aged , Aged , Respiration, Artificial , Critical Care , COVID-19/mortality , Intensive Care Units , Respiratory Distress Syndrome, Newborn , Retrospective Studies , Risk Factors
Bol. malariol. salud ambient ; 62(2): 233-240, 2022. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1379573


El objetivo del estudio fue determinar los factores asociados a mortalidad hospitalaria en pacientes con enfermedad por coronavirus 2019 (COVID-19). Se realizó un estudio observacional, analítico, de casos y controles. Se incluyeron pacientes hospitalizados con diagnóstico de la COVID-19 por prueba serológica y/o prueba molecular entre el marzo y agosto del 2020. Para el análisis estadístico se empleó la prueba de Mann Whitney y para el análisis de los factores asociados se utilizó regresión logística. La significancia de p-valor fue < 0,05. Se incluyó 814 pacientes, 556 (68,3%) fueron varones y 246 (30,2%) mayores de 60 años. La presencia de alguna comorbilidad se evidenció en 29,6 % (241 pacientes); 35,8% (292) fallecieron. La mediana de la edad de los fallecidos fue mayor en comparación a los sobrevivientes (59 vs 49; p>0,01). Las comorbilidades asociadas a la COVID-19 fueron: la obesidad (OR= 2,14; IC 95%: 1,38 ­ 3,32) y la hipertensión arterial (OR=1,86; IC 95%: 1,06-3,24). Asimismo, niveles de saturación de oxígeno menor al 85% al ingreso al hospital (OR= 3,58; IC 95%: 2,82- 4,53); la edad mayor a 60 años (OR=1,96; IC 95%: 1,54- 2,50) y el sexo masculino (OR= 1,64; IC95; 1,12-2,39) fueron asociados a mayor mortalidad. Finalmente, los factores asociados a mortalidad hospitalaria fueron saturación de oxígeno menor al 85% al ingreso al hospital, mayor de 60 años de edad, obesidad e hipertensión arterial(AU)

The objective of the study was to determine the factors associated with hospital mortality in patients with coronavirus disease 2019 (COVID-19). An observational, analytical, case-control study was conducted. Hospitalized patients diagnosed with COVID-19 by serological test and/or molecular test between March and August 2020 were included. The Mann Whitney test was used for statistical analysis and logistic regression was used for the analysis of associated factors. The significance of p-value was <0.05. A total of 814 patients were included, 556 (68.3%) were men and 246 (30.2%) were older than 60 years. The presence of some comorbidity was evidenced in 29.6% (241 patients); 35.8% (292) died. The median age of the deceased was higher compared to the survivors (59 vs. 49; p>0.01). The comorbidities associated with COVID-19 were: obesity (OR= 2.14; 95% CI: 1.38-3.32) and arterial hypertension (OR=1.86; 95% CI: 1.06- 3.24). Likewise, oxygen saturation levels less than 85% at hospital admission (OR= 3.58; 95% CI: 2.82-4.53); age over 60 years (OR=1.96; 95% CI: 1.54-2.50) and male gender (OR= 1.64; 95% CI: 1.12-2.39) were associated with greater mortality. Finally, the factors associated with hospital mortality were oxygen saturation less than 85% at hospital admission, older than 60 years of age, obesity, and arterial hypertension(AU)

Humans , Male , Adult , Middle Aged , Aged , Comorbidity , Hospital Mortality , COVID-19/mortality , Cardiovascular Diseases , Risk Factors , Oxygen Saturation , Hypertension , Obesity