Características clínicas e epidemiológicas de pacientes internados por infecção por SARS-CoV-2 em dois hospitais de Córdoba
Infecção por SARS-CoV-2 em pacientes hospitalizados
DOI:
https://doi.org/10.31053/1853.0605.v78.n3.32518Palavras-chave:
infecções por coronavirus, pneumonia, pacientes internados, prognóstico, betacoronavirusResumo
Introdução: A doença COVID-19 apresenta uma acentuada heterogeneidade em seu curso clínico, sendo descritos alguns fatores associados a um pior prognóstico. O conhecimento do comportamento da doença no cenário local é de grande relevância para permitir uma melhor abordagem.
Métodos: Estudo retrospectivo em dois hospitais da cidade de Córdoba, Argentina, de pacientes com 18 anos ou mais internados por infecção ativa de SARS-CoV-2, de março a outubro de 2020.
Resultados: foram incluídos 448 pacientes, dos quais 95,75% correspondiam a pneumonia COVID-19. A maioria dos episódios ocorreu em homens (63,6%), a mediana de idade foi de 63 anos (IQR: 53-75) e as comorbidades mais frequentes foram hipertensão arterial (55,1%), obesidade (31,7%) e diabetes mellitus (28,1%) ) 162 pacientes (36,2%) e 66 (14,7%) em ventilação mecânica necessitaram de internação em unidade de terapia intensiva. 67 (15%) pacientes morreram nos primeiros 30 dias de acompanhamento. Na análise multivariada, a única variável independente preditiva de mortalidade em 30 dias foi a idade (Odds ratio ajustada [ORa] = 1,08, IC 95% = 1,04-1,11, p <0,001). Os escores prognósticos 4C-Score e CALL-Score apresentaram discriminação muito boa (Área abaixo da curva [ABC] = 0,766, IC 95% = 0,72-0,80 e ABC = 0,785, IC 95% = 0,70-0,85 respectivamente) e os percentuais previstos de mortalidade foram bastante próximos ao observado no presente estudo.
Conclusões: A maioria dos pacientes internados por infecção por SARS-CoV-2 apresentava comorbidades e se apresentava como pneumonia, associada a alta mortalidade. Os escores prognósticos com melhor desempenho para predizer complicações foram o 4C-score e CALL-score.
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