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

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

PARÂMETROS CLÍNICOS E EPIDEMIOLÓGICOS NA COVID-19 E SUA CORRELAÇÃO COM ÓBITO EM PACIENTES ATENDIDOS EM UNIDADE DE TERAPIA INTENSIVA (UTI)

Introdução/Objetivo: Uma estratégia para compreender a forma grave da COVID-19 está voltada para avaliação de marcadores epidemiológicos, laboratoriais e clínicos capazes de predizer óbito. O presente estudo analisou marcadores epidemiológicos, biomarcadores clínicos e laboratoriais em participantes com COVID-19 grave internados em hospital de referência para tratamento da COVID-19 em Ilhéus/BA, com objetivo de determinar quais marcadores poderiam ser usados como preditores do óbito. Métodos: O estudo foi submetido ao CEP/UESC, aprovado sob CAAE n° 40671720.4.0000.5526. Realizado entre 11/06/2020 a 30/07/2021, onde foram coletados dados epidemiológicos, laboratoriais e clínicos dos prontuários de pacientes internados na UTI de um hospital de referência para COVID-19 em Ilhéus e cidades vizinhas, situadas no Sul da Bahia. Os dados foram registrados no software Epimed Monitor, passando por tratamento estatístico, respeitando categoria da variável: quantitativa ou categórica. As análises foram realizadas por softwares GraphPad Prism 9.0 e Statistical Package for Social Sciences 26.0. A classificação de sobreviventes e não sobreviventes foi analisada via curva ROC pelo método de Wilson/Brown. O estudo englobou 218 participantes com média de idade de 64,37SD± 15,16, 123 do sexo masculino e 95 do sexo feminino. 77 vieram a óbito. Resultados: As análises estatísticas evidenciaram idade superior a 65 anos (ponto de corte >66.5; p 40.5; p 0,895; p 19.4; p 1.350, p = 0.0035.) dosagem de pH arterial (ponto de corte 10.03; p 11,5; p < 0,001) foram associados ao óbito, correlacionados a injúria sistêmica. Conclusão: Os marcadores epidemiológicos, laboratoriais e clínicos encontrados neste estudo podem ser usados pela equipe clínica como preditores para óbito em pacientes com COVID-19

Table_1_Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital.DOCX

BackgroundPeople in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.Materials and methodsWe conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.ResultsThe use of bladder catheters (OR 79.30; p ConclusionWe suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU.</p