Mortality in a swiftly repurposed hospital in northeast Brazil during the first and second COVID-19 waves: A retrospective cohort study.

Autor:	Porto APM; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Neto JX; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil.; Secretaria de Saúde do Ceará, Fortaleza, Ceará, Brazil., Moreira FJF; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Júnior ABV; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., das Dores CCC; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Júnior ARC; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Deulefeu FC; Instituto de Saúde e Gestão Hospitalar, Fortaleza, Ceará, Brazil., Reis VAS; Instituto de Saúde e Gestão Hospitalar, Fortaleza, Ceará, Brazil., Severino RN; Instituto de Saúde e Gestão Hospitalar, Fortaleza, Ceará, Brazil., Severino FG; Instituto de Saúde e Gestão Hospitalar, Fortaleza, Ceará, Brazil., Freitas FADS; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Gois NB; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil.; Secretaria de Saúde do Ceará, Fortaleza, Ceará, Brazil., Santos AP; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Oliveira MF; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil., Sobrinho CRMR; Secretaria de Saúde do Ceará, Fortaleza, Ceará, Brazil., Holanda MA; Escola de Saúde Pública do Estado do Ceará Paulo Marcelo Martins Rodrigues, Fortaleza, Ceará, Brazil.
Jazyk:	angličtina
Zdroj:	IJID regions [IJID Reg] 2023 Jun; Vol. 7, pp. 182-190. Date of Electronic Publication: 2023 Mar 21.
DOI:	10.1016/j.ijregi.2023.03.009
Abstrakt:	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. Competing Interests: None declared. (© 2023 The Authors.)
Databáze:	MEDLINE
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