tetano
Editor, Senior Moderator
IJID Reg
. 2023 Jun;7:182-190.
doi: 10.1016/j.ijregi.2023.03.009. Epub 2023 Mar 21.
Mortality in a swiftly repurposed hospital in northeast Brazil during the first and second COVID-19 waves: A retrospective cohort study
Ana Paula M Porto[SUP] 1 [/SUP], José Xavier Neto[SUP] 1 2 [/SUP], Francisco Jadson Franco Moreira[SUP] 1 [/SUP], Antonio Brazil Viana Júnior[SUP] 1 [/SUP], Camila Campos C das Dores[SUP] 1 [/SUP], André R Castro Júnior[SUP] 1 [/SUP], Flávio C Deulefeu[SUP] 3 [/SUP], Virgínia A S Reis[SUP] 3 [/SUP], Rafaela N Severino[SUP] 3 [/SUP], Fernanda G Severino[SUP] 3 [/SUP], Francisco Aislan da Silva Freitas[SUP] 1 [/SUP], Nauber Bernardo Gois[SUP] 1 2 [/SUP], Artur P Santos[SUP] 1 [/SUP], Mayron F Oliveira[SUP] 1 [/SUP], Carlos Roberto M R Sobrinho[SUP] 2 [/SUP], Marcelo A Holanda[SUP] 1 [/SUP]; ResCOVID Task Force
Affiliations
Abstract
Background: The first months of the coronavirus disease 2019 (COVID-19) pandemic demanded rapid re-organization of available local resources. This study evaluated the performance of a private hospital in the Brazilian state of Ceará that was swiftly repurposed into a public tertiary COVID-19 centre during the first wave of the COVID-19 pandemic, and how it improved in the second wave.
Methods: This retrospective cohort study included 2492 patients with COVID-19 at Hospital Estadual Leonardo da Vinci (HELV) during the first and second waves. Demographic, clinical and laboratory data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality.
Results: Differences in demographics and clinical features were found between the two waves. There was reduced in-hospital mortality during the second wave (36.2%) in comparison with the first wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves {first wave: relative risk (RR) 4.28 [95% confidence interval (CI) 2.86-6.41], P<0.001; second wave: RR 12.94 (95% CI 3.4-49.12), P<0.001}.
Conclusions: HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate-to-severe cases and reduce the pressure on emergency and primary care facilities. Although mortality in intubated individuals remained high, there was an overall decrease in the in-hospital mortality rate in the second wave.
Keywords: Brazil; COVID-19; Mortality; Public health.
. 2023 Jun;7:182-190.
doi: 10.1016/j.ijregi.2023.03.009. Epub 2023 Mar 21.
Mortality in a swiftly repurposed hospital in northeast Brazil during the first and second COVID-19 waves: A retrospective cohort study
Ana Paula M Porto[SUP] 1 [/SUP], José Xavier Neto[SUP] 1 2 [/SUP], Francisco Jadson Franco Moreira[SUP] 1 [/SUP], Antonio Brazil Viana Júnior[SUP] 1 [/SUP], Camila Campos C das Dores[SUP] 1 [/SUP], André R Castro Júnior[SUP] 1 [/SUP], Flávio C Deulefeu[SUP] 3 [/SUP], Virgínia A S Reis[SUP] 3 [/SUP], Rafaela N Severino[SUP] 3 [/SUP], Fernanda G Severino[SUP] 3 [/SUP], Francisco Aislan da Silva Freitas[SUP] 1 [/SUP], Nauber Bernardo Gois[SUP] 1 2 [/SUP], Artur P Santos[SUP] 1 [/SUP], Mayron F Oliveira[SUP] 1 [/SUP], Carlos Roberto M R Sobrinho[SUP] 2 [/SUP], Marcelo A Holanda[SUP] 1 [/SUP]; ResCOVID Task Force
Affiliations
- PMID: 37063490
- PMCID: PMC10028252
- DOI: 10.1016/j.ijregi.2023.03.009
Abstract
Background: The first months of the coronavirus disease 2019 (COVID-19) pandemic demanded rapid re-organization of available local resources. This study evaluated the performance of a private hospital in the Brazilian state of Ceará that was swiftly repurposed into a public tertiary COVID-19 centre during the first wave of the COVID-19 pandemic, and how it improved in the second wave.
Methods: This retrospective cohort study included 2492 patients with COVID-19 at Hospital Estadual Leonardo da Vinci (HELV) during the first and second waves. Demographic, clinical and laboratory data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality.
Results: Differences in demographics and clinical features were found between the two waves. There was reduced in-hospital mortality during the second wave (36.2%) in comparison with the first wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves {first wave: relative risk (RR) 4.28 [95% confidence interval (CI) 2.86-6.41], P<0.001; second wave: RR 12.94 (95% CI 3.4-49.12), P<0.001}.
Conclusions: HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate-to-severe cases and reduce the pressure on emergency and primary care facilities. Although mortality in intubated individuals remained high, there was an overall decrease in the in-hospital mortality rate in the second wave.
Keywords: Brazil; COVID-19; Mortality; Public health.