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Santos TA, Oliveira JED, Fonseca CDD, Barbosa DA, Belasco AGDS, Miura CRM. Sepsis and COVID-19: outcomes in young adults in intensive care. Rev Bras Enferm 2023; 76:e20230037. [PMID: 38055486 DOI: 10.1590/0034-7167-2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to verify sepsis incidence among young adults admitted to intensive care due to COVID-19 and to analyze its association with demographic, clinical and outcome variables. METHODS a quantitative, longitudinal, retrospective and analytical study, consisting of 58 adults aged 20 to 40 years in intensive care for SARS-CoV-2. It was carried out in a university hospital, from March 2020 to December 2021, with data collected from electronic medical records. RESULTS sepsis incidence was 65%. Sepsis was associated with acute kidney injury, use of vasoactive drugs and mechanical ventilation, being admitted to the emergency room, severity according to the Simplified Acute Physiology Score III and bacterial pulmonary co-infection, the latter being the most frequent etiology for sepsis. CONCLUSIONS there was a high sepsis incidence, with 42% of deaths, which points to the importance of investing in preventive measures, especially in relation to bacterial pulmonary coinfections.
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Figueiredo ERL, Affonso MVDG, Jacomel RJ, Gomes FDC, Gonçalves NV, Miranda CDSC, da Silva MCF, da Silva-Júnior AF, de Melo-Neto JS. COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4639. [PMID: 36901646 PMCID: PMC10002208 DOI: 10.3390/ijerph20054639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 06/18/2023]
Abstract
This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.
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Affiliation(s)
| | | | | | - Fabiana de Campos Gomes
- Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, Brazil
| | - Nelson Veiga Gonçalves
- Laboratory of Epidemiology and Geoprocessing of Amazon, University of the state of Pará (UEPA), Belem 66050-540, Brazil
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Ventura MWS, Diógenes MDS, Albuquerque NLSD, Lima GA, Oliveira PMD, Alexandre ICU, Pascoal LM, Lima FET. Análise comparativa das características demográficas, sintomatologia e comorbidades de adultos e idosos notificados e confirmados com COVID-19 nas capitais brasileiras. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.38489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Objetivo: comparar o perfil demográfico, a sintomatologia e as comorbidades de adultos e idosos notificados com COVID-19 nas capitais brasileiras e no Distrito Federal. Métodos: estudo ecológico, desenvolvido a partir dos dados da plataforma online e-SUS Notifica, preenchidos até dia 4 de janeiro de 2021, com amostra constituída por 1.416.252 indivíduos, utilizando como critérios de inclusão: ter idade > 20 anos; residir nas capitais brasileiras ou no Distrito Federal; e apresentar resultado do teste positivo para COVID-19. A análise descritiva contou com a exposição das frequências absoluta e relativa e medidas de tendência central. Para análise inferencial, aplicou-se o teste qui-quadrado de Pearson, considerando diferença significativa para valores de p<0,05. Resultados: predominou sexo masculino (52%), com média de idade de 43,29 ± 14,85 anos. Os indivíduos apresentaram tosse (45,4%), febre (38,8%) e outros sintomas (83,1%). As comorbidades mais prevalentes foram: doenças cardíacas (7,1%) e diabetes (4,5%). Houve diferença significativa (p<0,001) entre as regiões brasileiras, ao comparar sexo, idade, ser profissional da saúde, sintomas e comorbidades. Conclusão: os dados contribuíram para o conhecimento acerca do processo epidêmico de COVID-19 no Brasil, no primeiro ano de pandemia, e demonstrou a distribuição dos casos e as relações existentes entre perfil demográfico, sintomatologia e doenças pré-existentes com os agrupados das capitais brasileiras.
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dos Reis EC, Rodrigues P, de Jesus TR, de Freitas Monteiro EL, Virtuoso Junior JS, Bianchi L. Risk of hospitalization and mortality due to COVID-19 in people with obesity: An analysis of data from a Brazilian state. PLoS One 2022; 17:e0263723. [PMID: 35245299 PMCID: PMC8896734 DOI: 10.1371/journal.pone.0263723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 01/25/2022] [Indexed: 12/29/2022] Open
Abstract
The aim of this article is to assess the odds ratio of hospitalization and mortality due to COVID-19 in people with obesity using data from residents of Espírito Santo, Brazil. An observational, quantitative, cross-sectional study was carried out from the database available on the official channel of the State Health Secretariat of Espírito Santo. Crude odds ratio estimates (ORs) referring to the association between variables were calculated, as well as adjusted odds ratios (adjusted odds ratios—OR adj.) and their respective 95% confidence intervals (CI 95%). The results indicate that men, non-white, no education or with lower education level and age over 40 years old were more likely to be hospitalized and died of COVID-19. People with obesity are at risk of hospitalization and death due to COVID-19 54% and 113% higher than people who do not have obesity. People with obesity had a higher chance of hospitalization when they were over 40 years old, had breathing difficulty, and the comorbidities diabetes (2.18 higher) and kidney disease (4.10 higher). The odds ratio of death for people with obesity over 60 years old was 12.51 higher, and those who were hospitalized was 17.9 higher compared to those who were not hospitalized.
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Affiliation(s)
- Erika Cardoso dos Reis
- Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- * E-mail:
| | - Phillipe Rodrigues
- School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatielle Rocha de Jesus
- Department of Integrated Health Education, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | | | - Lucas Bianchi
- National School of Public Health (ENSP/Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
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Sousa KMPD, Oliveira ASSD, Araujo EMD, Freitas HDS, Santiago JCDS, Barbosa SM. Adesão aos cuidados domésticos de casos suspeitos de Covid-19 em isolamento domiciliar. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0422pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar a associação entre as características sociodemográficas e a adesão aos cuidados domésticos de casos suspeitos de Covid-19 em isolamento domiciliar. Método: Estudo transversal, analítico. A coleta de dados ocorreu em unidade mista de saúde do Ceará, com 50 participantes suspeitos de Covid-19. Aplicou-se formulário de caracterização sociodemográfica, clínica e de avaliação dos cuidados em relação ao isolamento domiciliar. Para análise estatística, foram utilizados os testes Mann-Whitney e a razão de verossimilhança. Os princípios éticos das pesquisas com seres humanos foram seguidos. Resultados: A maioria dos homens (57,9%; p = 0,010) e das pessoas que conheciam alguém, pessoalmente, que teve/tem diagnóstico de Covid-19 (92,1%; p = 0,040) evitou aglomerações; 65,4% dos participantes com companheiro (a) descartaram o lixo adequadamente (p = 0,047); e 81,6% das pessoas com menor escolaridade aderiram à lavagem de roupas pessoais, de cama e toalhas com sabão comum e água (p = 0,043). Conclusão e implicações para a prática: As características sociodemográficas influenciaram a adesão a cuidados específicos, como evitamento de aglomerações, tratamento de lixo contaminado e lavagem de roupas pessoais, de cama e toalhas. Os cuidados domiciliares precisam ser mais enfatizados em consultas e pelos veículos de divulgação.
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Affiliation(s)
| | | | | | | | | | - Stella Maia Barbosa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Brasil
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Sousa KMPD, Oliveira ASSD, Araujo EMD, Freitas HDS, Santiago JCDS, Barbosa SM. Adherence to home care of suspected COVID -19 cases in home isolation. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0422en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Objective To analyze the association between sociodemographic characteristics and adherence to home care of suspected COVID-19 cases in home isolation. Method This is a cross-sectional, analytical study, and data collection took place in a health unit in Ceará, with 50 suspected COVID-19 participants. A sociodemographic, clinical characterization, and care evaluation form regarding home isolation was applied. For statistical analysis, the Mann-Whitney and likelihood ratio tests were used. The ethical principles of research with human beings were followed. Results Most men (57.9%; p = 0.010) and people who personally knew someone diagnosed with COVID-19 (92.1%; p = 0.040) avoided crowded places, 65.4% of the participants with a partner discarded the garbage properly (p = 0.047), and 81.6% of people with less education adhered to washing personal clothes, bedding, and towels with common soap and water (p = 0.043). Conclusions and implications for practice Sociodemographic characteristics influenced adherence to specific care, such as avoiding crowded places, treating contaminated waste, and washing personal clothes, bedding, and towels. Home care needs to be more emphasized in consultations and by means of dissemination.
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Affiliation(s)
| | | | | | | | | | - Stella Maia Barbosa
- Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Brasil
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de Lima EEC, Gayawan E, Baptista EA, Queiroz BL. Spatial pattern of COVID-19 deaths and infections in small areas of Brazil. PLoS One 2021; 16:e0246808. [PMID: 33571268 PMCID: PMC7877657 DOI: 10.1371/journal.pone.0246808] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 01/26/2021] [Indexed: 01/01/2023] Open
Abstract
As of mid-August 2020, Brazil was the country with the second-highest number of cases and deaths by the COVID-19 pandemic, but with large regional and social differences. In this study, using data from the Brazilian Ministry of Health, we analyze the spatial patterns of infection and mortality from Covid-19 across small areas of Brazil. We apply spatial autoregressive Bayesian models and estimate the risks of infection and mortality, taking into account age, sex composition of the population and other variables that describe the health situation of the spatial units. We also perform a decomposition analysis to study how age composition impacts the differences in mortality and infection rates across regions. Our results indicate that death and infections are spatially distributed, forming clusters and hotspots, especially in the Northern Amazon, Northeast coast and Southeast of the country. The high mortality risk in the Southeast part of the country, where the major cities are located, can be explained by the high proportion of the elderly in the population. In the less developed areas of the North and Northeast, there are high rates of infection among young adults, people of lower socioeconomic status, and people without access to health care, resulting in more deaths.
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Affiliation(s)
| | - Ezra Gayawan
- Department of Statistics, Federal University of Technology, Akure, Nigeria
| | | | - Bernardo Lanza Queiroz
- Department of Demography, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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