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Watanabe YJÁ, Carvalho LMR, Guedes JVM, Baldoni AO, Belo VS, Otoni A. Acute renal failure, COVID-19 and deaths, worrying rates in intensive care units: a cross-sectional study. SAO PAULO MED J 2024; 142:e2023150. [PMID: 39166611 PMCID: PMC11329267 DOI: 10.1590/1516-3180.2023.0150.r1.13052024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 03/15/2024] [Accepted: 05/13/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Acute kidney failure is a serious consequence of coronavirus disease 2019 (COVID-19). OBJECTIVES To identify the prevalence of COVID-19, kidney failure, frequency of death, and associated factors in patients receiving intensive care. DESIGN AND SETTING Analytical cross-sectional study conducted in the intensive care unit (ICU) of a medium-sized philanthropic general hospital in center-west Minas Gerais. METHODS Adults and older individuals who underwent real-time polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were evaluated by the nephrology team. RESULTS Among the 176 patients, the prevalence of COVID-19 and acute kidney injury (AKI) were 103 (58.5%) and 132 (75%), respectively, and 44 (25%) had chronic kidney disease (CKD) and 16 (15,5%) were positive for SARS-CoV-2. In the Charlson index classification, which estimates the risk of death, a statistically significant difference was identified in the percentages of groups with and without COVID-19 for indices 0, 1, and 2. There was a significant association between kidney disease and ICU mortality (P < 0.05). Patients with CKD had fewer fatal outcomes (13/97, 13.4%) than those with AKI (85/97, 87.6%). CONCLUSIONS COVID-19 rates remained high long after diagnosis and prevention of SARS-CoV-2 infection. In addition, a higher death rate among patients who developed AKI, whose prevalence was also greater than that in the national literature, regardless of the presence of COVID-19, revealed a worrying scenario and corroborated the need for early and judicious approaches to preserve the lives of patients with AKI admitted to intensive care units.
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Affiliation(s)
- Yoshimi José Ávila Watanabe
- Nefrologist, Physician, PhD Student, Postgraduate Program in Health Sciences, Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
| | - Lívia Maria Rezende Carvalho
- Undergraduate Nursing Student, Curso de Enfermagem, Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
| | - João Victor Marques Guedes
- Pharmacist, External Research Partner, Postgraduate Program in Health Sciences Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
| | - André Oliveira Baldoni
- Pharmacist, Associate Professor, Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
| | - Vinícius Silva Belo
- Biologist, Associate Professor, Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
| | - Alba Otoni
- Nurse, Associate Professor, Campus Centro Oeste (CCO), Universidade Federal de São João del-Rei (UFSJ), Divinópolis (MG), Brazil
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Oliveira GMMD, Brant LCC, Polanczyk CA, Malta DC, Biolo A, Nascimento BR, Souza MDFMD, Lorenzo ARD, Fagundes Júnior AADP, Schaan BD, Silva CGDSE, Castilho FMD, Cesena FHY, Soares GP, Xavier Junior GF, Barreto Filho JAS, Passaglia LG, Pinto Filho MM, Machline-Carrion MJ, Bittencourt MS, Pontes Neto OM, Villela PB, Teixeira RA, Stein R, Sampaio RO, Gaziano TA, Perel P, Roth GA, Ribeiro ALP. Cardiovascular Statistics - Brazil 2023. Arq Bras Cardiol 2024; 121:e20240079. [PMID: 38896747 PMCID: PMC11185831 DOI: 10.36660/abc.20240079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Affiliation(s)
- Gláucia Maria Moraes de Oliveira
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | - Luisa Campos Caldeira Brant
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | - Carisi Anne Polanczyk
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | | | - Andreia Biolo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | - Bruno Ramos Nascimento
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital Madre Teresa, Belo Horizonte, MG - Brasil
| | | | - Andrea Rocha De Lorenzo
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
| | | | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS - Brasil
| | - Christina Grüne de Souza E Silva
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | - Fábio Morato de Castilho
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | | | - Gabriel Porto Soares
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Curso de Medicina da Universidade de Vassouras, Vassouras, RJ - Brasil
| | | | | | - Luiz Guilherme Passaglia
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | - Marcelo Martins Pinto Filho
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
| | | | | | - Octavio M Pontes Neto
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), São Paulo, SP - Brasil
| | - Paolo Blanco Villela
- Instituto do Coração Edson Saad da Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ - Brasil
| | | | - Ricardo Stein
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil
| | - Roney Orismar Sampaio
- Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brasil
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | - Thomaz A Gaziano
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston - EUA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston - EUA
| | - Pablo Perel
- World Heart Federation, Geneva - Suíça
- Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, Londres - Inglaterra
| | - Gregory A Roth
- Division of Cardiology, Department of Medicine, University of Washington, Washington - EUA
| | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
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de Souza BR, Mazzuco E, Kemper LW. Previous Chronic Diseases and their Relationship with COVID-19 InfectionReplyDoenças crônicas não transmissíveis, risco e promoção da saúde: construções sociais de participantes do Vigitel. Arq Bras Cardiol 2022; 119:361-362. [PMID: 35946701 PMCID: PMC9363057 DOI: 10.36660/abc.20210859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Bruna Redivo de Souza
- Universidade do Sul de Santa CatarinaTubarãoSCBrasilUniversidade do Sul de Santa Catarina – UNISUL, Tubarão, SC – Brasil
| | - Eliane Mazzuco
- Universidade do Sul de Santa CatarinaTubarãoSCBrasilUniversidade do Sul de Santa Catarina – UNISUL, Tubarão, SC – Brasil
| | - Layse Wiggers Kemper
- Universidade do Sul de Santa CatarinaTubarãoSCBrasilUniversidade do Sul de Santa Catarina – UNISUL, Tubarão, SC – Brasil
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da Costa Sousa V, da Silva MC, de Mello MP, Guimarães JAM, Perini JA. Factors associated with mortality, length of hospital stay and diagnosis of COVID-19: Data from a field hospital. J Infect Public Health 2022; 15:800-805. [PMID: 35753155 PMCID: PMC9214823 DOI: 10.1016/j.jiph.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/05/2022] [Accepted: 06/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background During the pandemic of COVID-19, phylogenetic changes have been observed in the characteristics of the virus, in the diagnosis and treatment of the disease. The clinical course and the severe form of the disease depends on several factors. This study characterized the beginning setting for patient care of COVID-19 in a referral center in one of the main capital cities of Brazil. In addition, were evaluated the factors associated with mortality, length of stay, and diagnostic outcome. Methods A cross-sectional study was conducted during May 2020 (n = 1100). The association of the variables with outcome was evaluated by a multivariable logistic regression model, using odds ratios (OR) and 95 % confidence intervals (CI). Results Overall, 76 % of patients were COVID-19 positive, and 70 % were diagnosed by RT–qPCR. The majority were male (56 %), and over 52 years old (74 %), 68 % had hypertension, 44 % had diabetes mellitus, and 32 % were obese. The mean length of stay was 10 ± 8 days, which was higher in the 34 % who died (≥14; OR=2; 95 %CI=1.4–4) and who had hypertension (OR=2; 95 %CI=1.3–3) (P < 0.001). The mean length of stay was also higher (P = 0.008) for those patients with pulmonary impairment ≥ 50 % (10.72 ± 8.24), than those with< 50 % (8.98 ± 6.81). Age (>62 and 65 years) was associated with longer hospitalization (OR=2; 95 %CI=1.4–3) and death (OR=6; 95 %CI=3–11). The time of sample collection for RT–qPCR was different between positive and negative tests (P = 0.001), with the time of 4–10 days showing a greater chance for virus detection (OR=2.9; 95 %CI=1.6–5). Conclusion Death was associated with age and pulmonary impairment. The length of hospitalization was associated with age, hypertension, pulmonary impairment and death. The time of sample collection to perform RT–qPCR and the rapid test was associated with a positive result for COVID-19. These results highlight the ongoing challenge of diagnosing, treating, and mitigating the effects caused by the COVID-19 pandemic.
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Affiliation(s)
- Vanessa da Costa Sousa
- National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
| | - Mayara Calixto da Silva
- National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil; Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
| | - Matheus Pereira de Mello
- Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
| | | | - Jamila Alessandra Perini
- National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil; Pharmaceutical Sciences Research Laboratory (LAPESF), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil; National Institute of Traumatology and Orthopaedics (INTO), Research Division of INTO, Rio de Janeiro, RJ, Brazil.
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Lopes AJ, Litrento PF, Provenzano BC, Carneiro AS, Monnerat LB, da Cal MS, Ghetti ATA, Mafort TT. Small airway dysfunction on impulse oscillometry and pathological signs on lung ultrasound are frequent in post-COVID-19 patients with persistent respiratory symptoms. PLoS One 2021; 16:e0260679. [PMID: 34843598 PMCID: PMC8629296 DOI: 10.1371/journal.pone.0260679] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Thousands of people worldwide are suffering the consequences of coronavirus disease-2019 (COVID-19), and impulse oscillometry (IOS) and lung ultrasound (LUS) might be important tools for the follow-up of this population. Our objective was to prospectively evaluate abnormalities detected using these two methods in a cohort of COVID-19 survivors with respiratory symptoms. Methods In this follow-up study, 59 patients underwent clinical evaluations, spirometry, IOS and LUS in the 2nd (M1) and 5th (M2) months after diagnostic confirmation of COVID-19 by real-time reverse transcriptase–polymerase chain reaction. Aeration scores were obtained from the LUS exams based on the following findings: B-lines >2, coalescent B-lines, and subpleural consolidations. Results Fifty-nine (100%) participants had cough and/or dyspnea at M1, which decreased to 38 (64.4%) at M2 (p = 0.0001). Spirometry was abnormal in 26 (44.1%) and 20 (33.9%) participants at M1 and M2, respectively, although without statistical significance (p = 0.10). Normal examination, restrictive patterns, and obstructive patterns were observed in 33 (55.9%), 18 (30.5%), and 8 (13.6%) participants, respectively, at M1 and in 39 (66.1%), 13 (22%), and 7 (11.9%) participants at M2 (p = 0.14). Regarding IOS, considering changes in resistive and reactive parameters, abnormal exams were detected in 52 (88.1%) and 42 (71.2%) participants at M1 and M2, respectively (p = 0.002). Heterogeneity of resistance between 4 and 20 Hz >20% was observed in 38 (64.4%) and 33 (55.9%) participants at M1 and M2, respectively (p = 0.30). Abnormal LUS was observed in 46 (78%) and 36 (61%) participants at M1 and M2, respectively (p = 0.002), with a reduction in aeration scores between M1 and M2 [5 (2–8) vs. 3 (0–6) points, p<0.0001]. Conclusions IOS and LUS abnormalities are frequent in the first 5 months post-COVID-19 infection; however, when prospectively evaluated, significant improvement is evident in the parameters measured by these two methods.
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Affiliation(s)
- Agnaldo José Lopes
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro/RJ, Brazil
- * E-mail:
| | - Patrícia Frascari Litrento
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Bruna Cuoco Provenzano
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Alícia Sales Carneiro
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Laura Braga Monnerat
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mariana Soares da Cal
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Angelo Thomaz Abalada Ghetti
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Thiago Thomaz Mafort
- Department of Pulmonology, Piquet Carneiro Policlinic, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
- Medical Sciences Post-Graduation Programme, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Baggio JAO, Exel AL, Calles ACDN, Minatel V. Severe Acute Respiratory Distress Syndrome (ARDS) Caused by COVID-19: A Regional Factor. Arq Bras Cardiol 2021; 117:976-977. [PMID: 34817006 PMCID: PMC8682097 DOI: 10.36660/abc.20210803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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