Evaluation of the Risk of Clinical Deterioration among Inpatients with COVID-19.

Autor: Costa VO; Medicine, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora-SUPREMA, Juiz de Fora 36033-003, Brazil., Nicolini EM; Thoracic Surgery, Hospital Monte Sinai, Juiz de Fora 36033-318, Brazil., da Costa BMA; Nursing, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora-Suprema, Juiz de Fora 36033-003, Brazil., Teixeira FM; Medicine, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora-SUPREMA, Juiz de Fora 36033-003, Brazil., Ferreira JP; Medicine, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora-SUPREMA, Juiz de Fora 36033-003, Brazil., Moura MA; Infectology, Faculdade de Ciências Médicas e da Saúde de Juiz de Fora-Suprema, Juiz de Fora 36033-003, Brazil., Montessi J; Thoracic Surgery, Hospital Monte Sinai, Juiz de Fora 36033-318, Brazil., Campos RL; Psychiatrist and Emergency, Hospital Monte Sinai, Juiz de Fora 36033-318, Brazil., Guaraldo AN; Intensive Therapy, Hospital Monte Sinai, Juiz de Fora 36033-318, Brazil., Costa PM; Intensive Therapy and Dermatology Hospital Monte Sinai, Juiz de Fora 36033-318, Brazil.
Jazyk: angličtina
Zdroj: Advances in virology [Adv Virol] 2021 Jun 25; Vol. 2021, pp. 6689669. Date of Electronic Publication: 2021 Jun 25 (Print Publication: 2021).
DOI: 10.1155/2021/6689669
Abstrakt: This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants ( n  = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann-Whitney U test was taken for continuous variables and the chi-square test or Fisher's exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p  =   <0.001) and increases in serum creatinine ( p  = 0.009), LDH ( p  = 0.057), troponin ( p  = 0.018), IL-6 ( p  = 0.053), complement C4 ( p  = 0.040), and CRP ( p  = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p  = 0.001). Hypertension ( p  = 0.064), heart disease ( p  = 0.048), and COPD ( p  = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p  = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p  = 0.027), as well as bilateral opacifications ( p  = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.
Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article.
(Copyright © 2021 Víctor O. Costa et al.)
Databáze: MEDLINE
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