tetano
Editor, Senior Moderator
PLoS One
. 2021 Jan 7;16(1):e0244532.
doi: 10.1371/journal.pone.0244532. eCollection 2021.
Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study
Rodrigo A Brand?o Neto[SUP] 1 [/SUP], Julio F Marchini[SUP] 1 [/SUP], Lucas O Marino[SUP] 1 [/SUP], Julio C G Alencar[SUP] 1 [/SUP], Felippe Lazar Neto[SUP] 1 [/SUP], Sabrina Ribeiro[SUP] 1 [/SUP], Fernando V Salvetti[SUP] 1 [/SUP], Hassan Rahhal[SUP] 1 [/SUP], Luz Marina Gomez Gomez[SUP] 1 [/SUP], Caue G Bueno[SUP] 1 [/SUP], Carine C Faria[SUP] 1 [/SUP], Victor P da Cunha[SUP] 1 [/SUP], Eduardo Padr?o[SUP] 1 [/SUP], Irineu T Velasco[SUP] 1 [/SUP], Heraldo Possolo de Souza[SUP] 2 [/SUP], Emergencia USP Covid group
Affiliations
Abstract
Background: The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients.
Methods: From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others.
Results: From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality.
Conclusions: This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies.
Trial registration: The study was registered in the Brazilian registry of clinical trials: RBR-5d4dj5.
. 2021 Jan 7;16(1):e0244532.
doi: 10.1371/journal.pone.0244532. eCollection 2021.
Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study
Rodrigo A Brand?o Neto[SUP] 1 [/SUP], Julio F Marchini[SUP] 1 [/SUP], Lucas O Marino[SUP] 1 [/SUP], Julio C G Alencar[SUP] 1 [/SUP], Felippe Lazar Neto[SUP] 1 [/SUP], Sabrina Ribeiro[SUP] 1 [/SUP], Fernando V Salvetti[SUP] 1 [/SUP], Hassan Rahhal[SUP] 1 [/SUP], Luz Marina Gomez Gomez[SUP] 1 [/SUP], Caue G Bueno[SUP] 1 [/SUP], Carine C Faria[SUP] 1 [/SUP], Victor P da Cunha[SUP] 1 [/SUP], Eduardo Padr?o[SUP] 1 [/SUP], Irineu T Velasco[SUP] 1 [/SUP], Heraldo Possolo de Souza[SUP] 2 [/SUP], Emergencia USP Covid group
Affiliations
- PMID: 33411707
- DOI: 10.1371/journal.pone.0244532
Abstract
Background: The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients.
Methods: From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others.
Results: From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality.
Conclusions: This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies.
Trial registration: The study was registered in the Brazilian registry of clinical trials: RBR-5d4dj5.