Epidemiological profile of patients with COVID-19 in the ICU of a Reference Hospital in the South of Brazil: age as a risk factor for a worse outcome
DOI:
https://doi.org/10.33448/rsd-v11i2.25672Keywords:
Coronavirus; Pandemic; Mortality; Sars-Cov-2.Abstract
Introduction: The coronavirus epidemic, caused by SARS-CoV 2, reached the mark of 5.1 million deaths worldwide by November 2021. The virus affected different population profiles, but there are no data regarding demographic characteristics of patients admitted to intensive care. Objective: To describe the profile of patients who were treated with COVID-19 in the Intensive Care Unit of the University Hospital and to assess which variables were more related to mortality in these patients. Methodology: It is an exploratory descriptive-analytical cross-sectional study. Data were collected from November 2020 to March 2021, 93 patients admitted to the Intensive Care Unit (ICU) of the University Hospital (HU) by COVID-19. Results and discussion: Evaluating 93 patients, with a mean age of 60.4 ± 14.6 years (47 male), with a mean BMI of 31.4, 52.7% hypertensive, 47.3% obese, and 25.8% diabetics. We found a correlation between mortality and age (62.4x54.8; p:0.009). The correlation between length of stay assessed by median and the outcome of death was also significant (9x5.5; p:0.014). The most recurrent comorbidities were hypertension, the most prevalent, followed by obesity. The length of stay in the ICU was shorter due to the worsening clinical picture and the age of the patients. Conclusion: The study showed that elderly patients and patients with comorbidities had a worse prognosis of the disease, corroborating other studies already carried out.
References
Jain, V., & Yuan, J.-M. (2020). Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. International Journal of Public Health, 65(5), 533–546. https://doi.org/10.1007/s00038-020-01390-7
WHO Coronavirus (COVID-19) Dashboard. (n.d.). WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. https://covid19.who.int
Hussain, A., Mahawar, K., Xia, Z., Yang, W., & EL-Hasani, S. (2020). RETRACTED: Obesity and mortality of COVID-19. Meta-analysis. Obesity Research & Clinical Practice, 14(4), 295–300. https://doi.org/10.1016/j.orcp.2020.07.002
Rahman, A., & Sathi, N. J. (2020). Risk factors of the severity of COVID‐19: A meta‐analysis. International Journal of Clinical Practice. https://doi.org/10.1111/ijcp.13916
Lotfi, M., & Rezaei, N. (2020). SARS‐CoV‐2: A comprehensive review from pathogenicity of the virus to clinical consequences. Journal of Medical Virology, 92(10), 1864–1874. https://doi.org/10.1002/jmv.26123
Grasselli, G., Greco, M., Zanella, A., Albano, G., Antonelli, M., Bellani, G., Bonanomi, E., Cabrini, L., Carlesso, E., Castelli, G., Cattaneo, S., Cereda, D., Colombo, S., Coluccello, A., Crescini, G., Forastieri Molinari, A., Foti, G., Fumagalli, R., Iotti, G. A., … Cecconi, M. (2020). Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Internal Medicine, 180(10), 1345. https://doi.org/10.1001/jamainternmed.2020.3539
Bhargava, B., Abraham, P., Aggarwal, N., Babu, G., Barani, S., Bhatnagar, T., Dhama, A., Gangakhedkar, R., Giri, S., Gupta, N., Kurup, K., Manickam, P., Murhekar, M., Potdar, V., Praharaj, I., Rade, K., Reddy, D. C. S., Saravanakumar, V., Shah, N., … Yadav, N. (2020). Laboratory surveillance for SARS-CoV-2 in India: Performance of testing & descriptive epidemiology of detected COVID-19, January 22 - April 30, 2020. Indian Journal of Medical Research, 151(5), 424. https://doi.org/10.4103/ijmr.ijmr_1896_20
Abouhashem, A. S., Singh, K., Azzazy, H. M. E., & Sen, C. K. (2020). Is Low Alveolar Type II Cell SOD3 in the Lungs of Elderly Linked to the Observed Severity of COVID-19? Antioxidants & Redox Signaling, 33(2), 59–65. https://doi.org/10.1089/ars.2020.8111
Ahasic, A. M., Zhai, R., Su, L., Zhao, Y., Aronis, K. N., Thompson, B. T., Mantzoros, C. S., & Christiani, D. C. (2012). IGF1 and IGFBP3 in acute respiratory distress syndrome. European Journal of Endocrinology, 166(1), 121–129. https://doi.org/10.1530/eje-11-0778
Alessi, J., Berger de Oliveira, G., Wilke Franco, D., Amaral, B., Scalzilli Becker, A., Padilla Knijnik, C., Luiz Kobe, G., Rosa de Carvalho, T., Heiden Telo, G., Agord Schaan, B. D., & Heiden Telo, G. (2020). Mental Health in the Era of COVID-19: Prevalence of Psychiatric Disorders in a Cohort of Patients with Type 1 and Type 2 Diabetes During the Social Distancing. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3606443
Amar, J., Chabo, C., Waget, A., Klopp, P., Vachoux, C., Bermúdez‐Humarán, L. G., Smirnova, N., Bergé, M., Sulpice, T., Lahtinen, S., Ouwehand, A., Langella, P., Rautonen, N., Sansonetti, P. J., & Burcelin, R. (2011). Intestinal mucosal adherence and translocation of commensal bacteria at the early onset of type 2 diabetes: molecular mechanisms and probiotic treatment. EMBO Molecular Medicine, 3(9), 559–572. https://doi.org/10.1002/emmm.201100159
Asfahan, S., Deokar, K., Dutt, N., Niwas, R., Jain, P., & Agarwal, M. (2020). Extrapolation of mortality in COVID-19: Exploring the role of age, sex, co-morbidities and health-care related occupation. Monaldi Archives for Chest Disease, 90(2). https://doi.org/10.4081/monaldi.2020.1325
Azwar, M. K., Setiati, S., Rizka, A., Fitriana, I., Saldi, S., & Safitri, E. D. (2020). Clinical Profile of Elderly Patients with COVID-19 hospitalised in Indonesia's National General Hospital. Acta medica Indonesiana, 52(3), 199–205.
Baker, S. A., Kwok, S., Berry, G. J., & Montine, T. J. (2021). Angiotensin-converting enzyme 2 (ACE2) expression increases with age in patients requiring mechanical ventilation. PLOS ONE, 16(2), Artigo e0247060. https://doi.org/10.1371/journal.pone.0247060
Jain, V., & Yuan, J.-M. (2020a). Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. International Journal of Public Health, 65(5), 533–546. https://doi.org/10.1007/s00038-020-01390-7
O’Driscoll, M., Ribeiro Dos Santos, G., Wang, L., Cummings, D. A. T., Azman, A. S., Paireau, J., Fontanet, A., Cauchemez, S., & Salje, H. (2020). Age-specific mortality and immunity patterns of SARS-CoV-2. Nature. https://doi.org/10.1038/s41586-020-2918-0
Donoghue, M., Hsieh, F., Baronas, E., Godbout, K., Gosselin, M., Stagliano, N., Donovan, M., Woolf, B., Robison, K., Jeyaseelan, R., Breitbart, R. E., & Acton, S. (2000). A Novel Angiotensin-Converting Enzyme–Related Carboxypeptidase (ACE2) Converts Angiotensin I to Angiotensin 1-9. Circulation Research, 87(5). https://doi.org/10.1161/01.res.87.5.e1
Lambert, D. W., Yarski, M., Warner, F. J., Thornhill, P., Parkin, E. T., Smith, A. I., Hooper, N. M., & Turner, A. J. (2005). Tumor Necrosis Factor-α Convertase (ADAM17) Mediates Regulated Ectodomain Shedding of the Severe-acute Respiratory Syndrome-Coronavirus (SARS-CoV) Receptor, Angiotensin-converting Enzyme-2 (ACE2). Journal of Biological Chemistry, 280(34), 30113–30119. https://doi.org/10.1074/jbc.m505111200
Iwata, M., Silva Enciso, J. E., & Greenberg, B. H. (2009). Selective and specific regulation of ectodomain shedding of angiotensin-converting enzyme 2 by tumor necrosis factor α-converting enzyme. American Journal of Physiology-Cell Physiology, 297(5), C1318—C1329. https://doi.org/10.1152/ajpcell.00036.2009
Sama, I. E., Ravera, A., Santema, B. T., van Goor, H., ter Maaten, J. M., Cleland, J. G. F., Rienstra, M., Friedrich, A. W., Samani, N. J., Ng, L. L., Dickstein, K., Lang, C. C., Filippatos, G., Anker, S. D., Ponikowski, P., Metra, M., van Veldhuisen, D. J., & Voors, A. A. (2020). Circulating plasma concentrations of angiotensin-converting enzyme 2 in men and women with heart failure and effects of renin–angiotensin–aldosterone inhibitors. European Heart Journal, 41(19), 1810–1817. https://doi.org/10.1093/eurheartj/ehaa373
Culebras, E., & Hernández, F. (2020). ACE2 is on the X chromosome: could this explain COVID-19 gender differences? European Heart Journal, 41(32), 3095. https://doi.org/10.1093/eurheartj/ehaa521
Zeiser, F. A., Donida, B., da Costa, C. A., Ramos, G. d. O., Scherer, J. N., Barcellos, N. T., Alegretti, A. P., Ikeda, M. L. R., Müller, A. P. W. C., Bohn, H. C., Santos, I., Boni, L., Antunes, R. S., Righi, R. d. R., & Rigo, S. J. (2021). First and Second COVID-19 Waves in Brazil: A Cross-Sectional Study of Patients’ Characteristics Related to In-Hospital Mortality. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3894389
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Copyright (c) 2022 Alberto Roloff Kruger; Cédrik da Veiga Vier; Augusto Antonio Botelho Queiroz Saute; Diogo Noronha Menezes Kreutz; Leticia Kunst; Diego da Rosa Miltersteiner ; Luis Carlos Porcello Marrone; Maria Isabel Morgan Martins
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