Complications in hospitalized patients with SARS-CoV2 infection
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Palavras-chave

complications, covid-19, sars-cov2

Como Citar

de Souza Borges Tavares , M. A., Bisinotto Skaff , G., Gomes Fredrich, I. M., Nery Ayach, M., Quarti Vieira, I. A., Martins Bertoncelo, B., Fernanda dos Santos , T., Dresch, H., Kato da Silva, B. A., Costa Marques, M., Vieira , B., & Alves Dias, R. V. (2023). Complications in hospitalized patients with SARS-CoV2 infection. Brazilian Journal of Implantology and Health Sciences, 5(3), 295–312. https://doi.org/10.36557/2674-8169.2023v5n3p295-312

Resumo

OBJECTIVES: The present study aimed to assess the prevalence of complications during hospitalization in patients diagnosed with COVID-19, as well as the association with mortality and prognosis. METHODS: A retrospective cohort study involved 306 patients admitted to a COVID ward and ICU aged 18 years or older with confirmed SARS-CoV2 infection admitted to a Brazilian Tertiary Hospital. Demographic, clinical, biochemical, radiological and outcome data were collected from the patients' charts. RESULTS: According to the data analyzed during hospitalization, 230 (75.2%) patients developed complications, 281 (91.8%) patients had comorbidities and 169 (55.2%) patients died. There are no differences regarding the sex of the patients. The most prevalent complication was ventilator-associated pneumonia, present in 130 (42.5%) patients, followed by acute kidney injury or chronic kidney disease requiring hemodialysis, presented by 100 (32.7%) patients. The calculation of the relative risk of death according to the occurrence of complications showed p<0.0001 for acute renal failure, p<0.0001 for orotracheal intubation and p=0.0434 for acute myocardial infarction. CONCLUSION: The relative risk of death in COVID-19 is significant, showing an increase in relation to age, length of hospital stay and complications. Prevention, early diagnosis and appropriate treatment are essential to reduce the mortality rate in patients with SARS-CoV-2 infection.

https://doi.org/10.36557/2674-8169.2023v5n3p295-312
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Referências

Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, Ng OT, Marimuthu K, Ang LW, Mak TM, Lau SK, Anderson DE, Chan KS, Tan TY, Ng TY, Cui L, Said Z, Kurupatham L, Chen MI, Chan M, Vasoo S, Wang LF, Tan BH, Lin RTP, Lee VJM, Leo YS, Lye DC; Singapore 2019 Novel Coronavirus Outbreak Research Team. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020 Apr 21;323(15):1488-1494. doi: 10.1001/jama.2020.3204. Erratum in: JAMA. 2020 Apr 21;323(15):1510. PMID: 32125362; PMCID: PMC7054855.

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. PMID: 32091533.

Gabarre P, Dumas G, Dupont T, Darmon M, Azoulay E, Zafrani L. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med. 2020 Jul;46(7):1339-1348. doi: 10.1007/s00134-020-06153-9. Epub 2020 Jun 12. PMID: 32533197; PMCID: PMC7290076.

Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, Kaptein FHJ, van Paassen J, Stals MAM, Huisman MV, Endeman H. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020 Jul;191:145-147. doi: 10.1016/j.thromres.2020.04.013. Epub 2020 Apr 10. PMID: 32291094; PMCID: PMC7146714.

El Moheb M, Naar L, Christensen MA, Kapoen C, Maurer LR, Farhat M, Kaafarani HMA. Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19. JAMA. 2020 Nov 10;324(18):1899-1901. doi: 10.1001/jama.2020.19400. Erratum in: JAMA. 2021 Mar 16;325(11):1113. PMID: 32970139; PMCID: PMC7516799.

Pleasure SJ, Green AJ, Josephson SA. The Spectrum of Neurologic Disease in the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic Infection: Neurologists Move to the Frontlines. JAMA Neurol. 2020 Jun 1;77(6):679-680. doi: 10.1001/jamaneurol.2020.1065. Erratum in: JAMA Neurol. 2020 Jun 1;77(6):776. PMID: 32275291.

Bernheim A, Mei X, Huang M, Yang Y, Fayad ZA, Zhang N, Diao K, Lin B, Zhu X, Li K, Li S, Shan H, Jacobi A, Chung M. Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. 2020 Jun;295(3):200463. doi: 10.1148/radiol.2020200463. Epub 2020 Feb 20. PMID: 32077789; PMCID: PMC7233369.

Tan SW, Tam YC, Oh CC. Skin manifestations of COVID-19: A worldwide review. JAAD Int. 2021 Mar;2:119-133. doi: 10.1016/j.jdin.2020.12.003. Epub 2020 Dec 16. PMID: 33479703; PMCID: PMC7754879.

Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, Aaron JG, Claassen J, Rabbani LE, Hastie J, Hochman BR, Salazar-Schicchi J, Yip NH, Brodie D, O'Donnell MR. Epidemiologia, curso clínico e resultados de adultos gravemente doentes com COVID-19 na cidade de Nova York: um estudo de coorte prospectivo. Lancet. 2020 Jun 6;395(10239):1763-1770. doi: 10.1016/S0140-6736(20)31189-2. Epub 2020 19 de maio. PMID: 32442528; PMCID: PMC7237188.

Simadibrata DM, Lubis AM. D-dimer levels on admission and all-cause mortality risk in COVID-19 patients: a meta-analysis. Epidemiol Infect. 2020 Sep 7;148:e202. doi: 10.1017/S0950268820002022. PMID: 32892787; PMCID: PMC7487805.

Pecly, Inah Maria D. et al. A review of Covid-19 and acute kidney injury: from pathophysiology to clinical results. Brazilian Journal of Nephrology [online]. 2021, v. 43, n. 4 [Acessado 11 Março 2022], pp. 551-571. Disponível em: <https://doi.org/10.1590/2175-8239-JBN-2020-0204>. Epub 28 Maio 2021. ISSN 2175-8239. https://doi.org/10.1590/2175-8239-JBN-2020-0204.

Marazuela M, Giustina A, Puig-Domingo M (2020) Aspectos endócrinos e metabólicos da pandemia de COVID-19. Rev Endocr Metab Disord 21: 495–507. https://doi.org/10.1007/s11154-020-09569-2

Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020 May 12;323(18):1775-1776. doi: 10.1001/jama.2020.4683. Erratum in: JAMA. 2020 Apr 28;323(16):1619. PMID: 32203977.

Grasselli G, Scaravilli V, Mangioni D, Scudeller L, Alagna L, Bartoletti M, Bellani G, Biagioni E, Bonfanti P, Bottino N, Coloretti I, Cutuli SL, De Pascale G, Ferlicca D, Fior G, Forastieri A, Franzetti M, Greco M, Guzzardella A, Linguadoca S, Meschiari M, Messina A, Monti G, Morelli P, Muscatello A, Redaelli S, Stefanini F, Tonetti T, Antonelli M, Cecconi M, Foti G, Fumagalli R, Girardis M, Ranieri M, Viale P, Raviglione M, Pesenti A, Gori A, Bandera A. Hospital-Acquired Infections in Critically Ill Patients With COVID-19. Chest. 2021 Aug;160(2):454-465. doi: 10.1016/j.chest.2021.04.002. Epub 2021 Apr 20. PMID: 33857475; PMCID: PMC8056844

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Jan 30;: PMID: 31986264; PMCID: PMC7159299.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. PMID: 32171076; PMCID: PMC7270627.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. PMID: 32007143; PMCID: PMC7135076.

Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG; ISARIC4C investigators. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020 May 22;369:m1985. doi: 10.1136/bmj.m1985. PMID: 32444460; PMCID: PMC7243036.

Virot E, Mathien C, Pointurier V, Poidevin A, Labro G, Pinto L, Jandeaux LM, Mootien J, Kuteifan K. Characterization of pulmonary impairment associated with COVID-19 in patients requiring mechanical ventilation. Rev Bras Ter Intensiva. 2021 Jan-Mar;33(1):75-81. doi: 10.5935/0103-507X.20210007. PMID: 33886855; PMCID: PMC8075326.

Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. 2020;323(15):1499–1500. doi:10.1001/jama.2020.3633

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113. PMID: 32031570; PMCID: PMC7042881.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. PMID: 32007143; PMCID: PMC7135076.

Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, Tobin KA, Cerfolio RJ, Francois F, Horwitz LI. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020 May 22;369:m1966. doi: 10.1136/bmj.m1966. PMID: 32444366; PMCID: PMC7243801.

Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, Lee M. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA. 2020 Apr 28;323(16):1612-1614. doi: 10.1001/jama.2020.4326. PMID: 32191259; PMCID: PMC7082763.

Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, Mehra MR, Schuepbach RA, Ruschitzka F, Moch H. Endothelial cell infection and endotheliitis

Asghar MS, Haider Kazmi SJ, Khan NA, Akram M, Hassan M, Rasheed U, Ahmed Khan S. Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country. Cureus. 2020 Aug 5;12(8):e9575. doi: 10.7759/cureus.9575. PMID: 32913691; PMCID: PMC7474562.

Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, Chang BP, Chau KH, Choi JJ, Gavin N, Goyal P, Mills AM, Patel AA, Romney MS, Safford MM, Schluger NW, Sengupta S, Sobieszczyk ME, Zucker JE, Asadourian PA, Bell FM, Boyd R, Cohen MF, Colquhoun MI, Colville LA, de Jonge JH, Dershowitz LB, Dey SA, Eiseman KA, Girvin ZP, Goni DT, Harb AA, Herzik N, Householder S, Karaaslan LE, Lee H, Lieberman E, Ling A, Lu R, Shou AY, Sisti AC, Snow ZE, Sperring CP, Xiong Y, Zhou HW, Natarajan K, Hripcsak G, Chen R. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020 May 29;369:m1996. doi: 10.1136/bmj.m1996. PMID: 32471884; PMCID: PMC7256651.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium, Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052-2059. doi: 10.1001/jama.2020.6775. Erratum in: JAMA. 2020 May 26;323(20):2098. PMID: 32320003; PMCID: PMC7177629.

Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, Ross M, Forest S, Goldstein YD, Ajaimy M, Liriano-Ward L, Pynadath C, Loarte-Campos P, Nandigam PB, Graham J, Le M, Rocca J, Kinkhabwala M. Covid-19 and Kidney Transplantation. N Engl J Med. 2020 Jun 18;382(25):2475-2477. doi: 10.1056/NEJMc2011117. Epub 2020 Apr 24. PMID: 32329975; PMCID: PMC7200055.

Liotta EM, Batra A, Clark JR, Shlobin NA, Hoffman SC, Orban ZS, Koralnik IJ. Frequent neurologic manifestations and encephalopathy-associated morbidity in Covid-19 patients. Ann Clin Transl Neurol. 2020 Nov;7(11):2221-2230. doi: 10.1002/acn3.51210. Epub 2020 Oct 5. PMID: 33016619; PMCID: PMC7664279.

Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger JS. Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA. 2020 Aug 25;324(8):799-801. doi: 10.1001/jama.2020.13372. PMID: 32702090; PMCID: PMC7372509.

Saad M, Kennedy KF, Imran H, et al. Association Between COVID-19 Diagnosis and In-Hospital Mortality in Patients Hospitalized With ST-Segment Elevation Myocardial Infarction. JAMA. 2021;326(19):1940–1952. doi:10.1001/jama.2021.18890

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020 Mar 28;395(10229):1033-1034. doi: 10.1016/S0140-6736(20)30628-0. Epub 2020 Mar 16. PMID: 32192578; PMCID: PMC7270045.

Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, Xiao W, Wang YN, Zhong MH, Li CH, Li GC, Liu HG. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020 May 5;133(9):1025-1031. doi: 10.1097/CM9.0000000000000744. PMID: 32044814; PMCID: PMC7147277.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020 Mar 26;368:m1091. doi: 10.1136/bmj.m1091. Erratum in: BMJ. 2020 Mar 31;368:m1295. PMID: 32217556; PMCID: PMC7190011.

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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

Copyright (c) 2023 Marco Antônio de Souza Borges Tavares , Gabriela Bisinotto Skaff , Isadora Martins Gomes Fredrich, Mariana Nery Ayach, Isabela Anuda Quarti Vieira, Beatriz Martins Bertoncelo, Tauanne Fernanda dos Santos , Henrique Dresch, Baldomero Antônio Kato da Silva, Mariana Costa Marques, Robson Vinícius Alves Dias

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