Comparative assessment of mortality risk factors between admission and follow-up models among patients hospitalized with COVID-19

Autor: Guilherme A. Salzstein, Felippe Lazar Neto, Fábio C. de Assis, Marilia Ribeiro de Azevedo Aguiar, Júlio César de Oliveira, Rodrigo H. Kondo, Thaís Bastos, Gerhard da Paz Lauterbach, Augusto César Ferreira de Moraes, Felipe Carvalho Barros Sousa, André L. Cortez, Daniel Fernandes Duailibi, Fabíola Vieira Duarte Baptista, Milton A. Martins, Marcos Felipe D.S. Dias, Aline A. de Deus, Joanne Alves Moreira
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Male
medicine.medical_treatment
Comorbidity
Infectious and parasitic diseases
RC109-216
Cohort Studies
0302 clinical medicine
Risk Factors
030212 general & internal medicine
Covid-19 - Brasil
Hospital Mortality
Mortality rate
Follow-up
Hazard ratio
General Medicine
Middle Aged
Prognosis
Hospitalization
Doentes hospitalizados
Infectious Diseases
Mortalidade
Female
Brazil
Cohort study
Microbiology (medical)
medicine.medical_specialty
Respiratory rate
030106 microbiology
Models
Biological
Article
03 medical and health sciences
Internal medicine
medicine
Humans
Mortality
Proportional Hazards Models
Retrospective Studies
Mechanical ventilation
Fatores de risco
Proportional hazards model
business.industry
SARS-CoV-2
COVID-19
Retrospective cohort study
medicine.disease
Respiration
Artificial
Coronavirus
business
Follow-Up Studies
Zdroj: International Journal of Infectious Diseases, Vol 105, Iss, Pp 723-729 (2021)
International Journal of Infectious Diseases
Repositório Institucional da UnB
Universidade de Brasília (UnB)
instacron:UNB
ISSN: 1201-9712
Popis: Objectives: This study aimed to compare differences in mortality risk factors between admission and follow-up incorporated models. Methods: A retrospective cohort study of 524 patients with confirmed COVID-19 infection admitted to a tertiary medical center in São Paulo, Brazil from 13 March to 30 April 2020. Data were collected on admission, and the third, eighth and fourteenth days of hospitalization. The hazard ratio (HR) was calculated and 28-day in-hospital mortality risk factors were compared between admission and follow-up models using a time-dependent Cox regression model. Results: Of 524 patients, 50.4% needed mechanical ventilation. The 28-day mortality rate was 32.8%. Compared with follow-up, admission models under-estimated the mortality HR for peripheral oxygen saturation 100 bpm (1.19 versus 2.04), respiratory rate >24/min (1.01 versus 1.82) and mechanical ventilation (1.92 versus 12.93). Low oxygen saturation, higher oxygen support and more biomarkers–including lactate dehydrogenase, C-reactive protein, neutrophil-lymphocyte ratio, and urea remained associated with mortality after adjustment for clinical factors at follow-up compared with only urea and oxygen support at admission. Conclusions: The inclusion of follow-up measurements changed mortality hazards of clinical signs and biomarkers. Low oxygen saturation, higher oxygen support, lactate dehydrogenase, C-reactive protein, neutrophil-lymphocyte ratio, and urea could help with prognosis of patients during follow-up.
Databáze: OpenAIRE
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