1
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Trott G, Scolari FL, Rover MM, da Silva MMD, de Souza D, dos Santos RDRM, Schardosim RFDC, Rech GS, de Mesquita J, Estivalete GP, Freitas HJM, Itaqui CR, Kozesinski-Nakatani AC, Biolo A, Marcolino MS, Barreto BB, Schvartzman PR, Antonio ACP, Robinson CC, Falavigna M, Polanczyk CA, Rosa RG. Long-term Health-Related Quality of Life and Outcomes after Hospitalization for COVID-19 in Brazil: Post-COVID Brazil 1 Study Protocol. Arq Bras Cardiol 2023; 120:e20230378. [PMID: 37991122 PMCID: PMC10697686 DOI: 10.36660/abc.20230378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 08/16/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The long-term impact of hospitalization for COVID-19 on patients' physical, mental, and cognitive health still needs further assessment. OBJECTIVES This study aims to evaluate factors associated with quality of life and cardiovascular and non-cardiovascular outcomes 12 months after hospitalization for COVID-19. METHODS This prospective multicenter study intends to enroll 611 patients hospitalized due to COVID-19 (NCT05165979). Centralized telephone interviews are scheduled to occur at three, six, nine, and 12 months after hospital discharge. The primary endpoint is defined as the health-related quality-of-life utility score assessed by the EuroQol-5D-3L (EQ-5D-3L) questionnaire at 12 months. Secondary endpoints are defined as the EQ-5D-3L at three, six and nine months, return to work or education, persistent symptoms, new disabilities in instrumental activities of daily living, cognitive impairment, anxiety, depression, and post-traumatic stress symptoms, major cardiovascular events, rehospitalization, as well as all-cause mortality at 3, 6, 9, and 12 months after SARS-CoV-2 infection. A p-value <0.05 will be assumed as statistically significant for all analyses. RESULTS The primary endpoint will be presented as the frequency of the EQ-5D-3L score 12 months after COVID-19 hospitalization. A sub-analysis to identify possible associations of independent variables with study outcomes will be presented. CONCLUSIONS This study will determine the impact of COVID-19 on the quality of life and cardiovascular and non-cardiovascular outcomes of hospitalized patients 12 months after discharge providing insights to the public health system in Brazil.
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Affiliation(s)
- Geraldine Trott
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Fernando Luis Scolari
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Divisão de Cardiologia do Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Marciane Maria Rover
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Divisão de Cardiologia do Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Mariana Motta Dias da Silva
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Denise de Souza
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Rosa da Rosa Minho dos Santos
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Raíne Fogliati de Carli Schardosim
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Gabriela Soares Rech
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Juliana de Mesquita
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Gabriel Pozza Estivalete
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Hellen Jordan Martins Freitas
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Carolina Rothmann Itaqui
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Amanda Christina Kozesinski-Nakatani
- Unidade de Terapia IntensivaHospital Santa Casa de CuritibaCuritibaPRBrasil Unidade de Terapia Intensiva – Hospital Santa Casa de Curitiba , Curitiba , PR – Brasil
| | - Andreia Biolo
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Divisão de Cardiologia do Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Instituto Nacional de Avaliação de Tecnologias em SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasil Instituto Nacional de Avaliação de Tecnologias em Saúde – Universidade Federal do Rio Grande do Sul , Porto Alegre , RS – Brasil
| | - Milena Soriano Marcolino
- Departamento de Medicina InternaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Medicina Interna da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - Bruna Brandão Barreto
- Departamento de Medicina Interna e Apoio DiagnósticoFaculdade de Medicina da BahiaUniversidade Federal da BahiaSalvadorBABrasil Departamento de Medicina Interna e Apoio Diagnóstico , Faculdade de Medicina da Bahia , Universidade Federal da Bahia , Salvador , BA – Brasil
- Unidade de Terapia IntensivaHospital da Mulher – Maria Luzia Costa dos SantosSalvadorBABrasil Unidade de Terapia Intensiva – Hospital da Mulher – Maria Luzia Costa dos Santos , Salvador , BA – Brasil
| | - Paulo Roberto Schvartzman
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Divisão de Cardiologia do Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Ana Carolina Peçanha Antonio
- Unidade de Terapia IntensivaHospital de Clínicas de Porto AlegrePorto AlegreRSBrasil Unidade de Terapia Intensiva – Hospital de Clínicas de Porto Alegre , Porto Alegre , RS – Brasil
| | - Caroline Cabral Robinson
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
| | - Maicon Falavigna
- Instituto Nacional de Avaliação de Tecnologias em SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasil Instituto Nacional de Avaliação de Tecnologias em Saúde – Universidade Federal do Rio Grande do Sul , Porto Alegre , RS – Brasil
- Unidade de PesquisaInova MedicalPorto AlegreRSBrasil Unidade de Pesquisa – Inova Medical , Porto Alegre , RS – Brasil
| | - Carisi Anne Polanczyk
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasil Divisão de Cardiologia do Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Instituto Nacional de Avaliação de Tecnologias em SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasil Instituto Nacional de Avaliação de Tecnologias em Saúde – Universidade Federal do Rio Grande do Sul , Porto Alegre , RS – Brasil
| | - Regis Goulart Rosa
- Escritório de Projetos de PesquisaHospital Moinhos de VentoPorto AlegreRSBrasil Escritório de Projetos de Pesquisa – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
- Serviço de Medicina InternaHospital Moinhos de VentoPorto AlegreRSBrasil Serviço de Medicina Interna – Hospital Moinhos de Vento , Porto Alegre , RS – Brasil
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2
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Rover MM, Trott G, Scolari FL, da Silva MMD, de Souza D, dos Santos RDRM, Dagnino APA, de Mesquita J, Estivalete GP, Kozesinski-Nakatani AC, Marcolino MS, Barreto BB, Schvartzman PR, Antonio ACP, Robinson CC, Falavigna M, Biolo A, Polanczyk CA, Rosa RG. Health-Related Quality of Life and Long-Term Outcomes after Mildly Symptomatic COVID-19: The Post-COVID Brazil Study 2 Protocol. Arq Bras Cardiol 2023; 120:e20220835. [PMID: 37851732 PMCID: PMC10547435 DOI: 10.36660/abc.20220835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The long-term effects of mild COVID-19 on physical, cognitive, and mental health are not yet well understood. OBJECTIVE The purpose of this paper is to describe the protocol for the ongoing "Post-COVID Brazil" study 2, which aims to evaluate the factors associated with health-related quality of life and long-term cardiovascular and non-cardiovascular outcomes one year after a mild episode of symptomatic COVID-19. METHODS The "Post-COVID Brazil" study 2 is a prospective multicenter study that plans to enroll 1047 patients (NCT05197647). Centralized, structured telephone interviews are conducted at 1, 3, 6, 9, and 12 months after COVID-19 diagnosis. The primary outcome is the health-related quality-of-life utility score, assessed using the EuroQol-5D-3L (EQ-5D-3L) questionnaire at 12 months. Secondary endpoints include the EQ-5D-3L at 3, 6, and 9 months, as well as all-cause mortality, major cardiovascular events, hospitalization, return to work or education, persistent symptoms, new disabilities in instrumental activities of daily living, cognitive impairment, anxiety, depression, and post-traumatic stress symptoms at 3, 6, 9, and 12 months after SARS-CoV-2 infection. A p-value < 0.05 will be considered statistically significant for all analyses. RESULTS The primary endpoint will be presented as the overall frequency of the EQ-5D-3L domains 12 months after SARS-CoV-2 infection. Main analysis will explore the association of independent variables with the study outcomes. CONCLUSION The "Post-COVID Brazil" study 2 aims to clarify the impact of long COVID on the quality of life and cardiovascular and non-cardiovascular outcomes of Brazilian patients who have had mild COVID-19.
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Affiliation(s)
- Marciane Maria Rover
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Geraldine Trott
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Fernando Luís Scolari
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Mariana Motta Dias da Silva
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Denise de Souza
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Rosa da Rosa Minho dos Santos
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Ana Paula Aquistapase Dagnino
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Juliana de Mesquita
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Gabriel Pozza Estivalete
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Amanda Christina Kozesinski-Nakatani
- Unidade de Terapia IntensivaHospital Santa Casa de CuritibaCuritibaPRBrasilUnidade de Terapia Intensiva – Hospital Santa Casa de Curitiba, Curitiba, PR – Brasil
| | - Milena Soriano Marcolino
- Universidade Federal de Minas GeraisBelo HorizonteMGBrasilMedicina Interna – Universidade Federal de Minas Gerais, Belo Horizonte, MG – Brasil
| | - Bruna Brandão Barreto
- Departamento de Medicina Interna e Apoio DiagnósticoFaculdade de Medicina da BahiaUniversidade Federal da BahiaSalvadorBABrasilDepartamento de Medicina Interna e Apoio Diagnóstico – Faculdade de Medicina da Bahia – Universidade Federal da Bahia Salvador, BA – Brasil
- Unidade de Terapia IntensivaHospital da Mulher – Maria Luzia Costa dos SantosSalvadorBABrasilUnidade de Terapia Intensiva – Hospital da Mulher – Maria Luzia Costa dos Santos, Salvador, BA – Brasil
| | - Paulo Roberto Schvartzman
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Ana Carolina Peçanha Antonio
- Unidade de Terapia IntensivaHospital de Clínicas de Porto AlegrePorto AlegreRSBrasilUnidade de Terapia Intensiva – Hospital de Clínicas de Porto Alegre, Porto Alegre, RS – Brasil
| | - Caroline Cabral Robinson
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
| | - Maicon Falavigna
- Unidade de PesquisaInova MedicalPorto AlegreRSBrasilUnidade de Pesquisa – Inova Medical, Porto Alegre, RS – Brasil
- Instituto Nacional de Avaliação de Tecnologias em SaúdeUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasilInstituto Nacional de Avaliação de Tecnologias em Saúde – Universidade Federal do Rio Grande do Sul, Porto Alegre, RS – Brasil
| | - Andreia Biolo
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasilFaculdade de Medicina – Universidade Federal do Rio Grande do Sul, Porto Alegre, RS – Brasil
| | - Carisi Anne Polanczyk
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
- Divisão de CardiologiaHospital Moinhos de VentoPorto AlegreRSBrasilDivisão de Cardiologia – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
- Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreRSBrasilFaculdade de Medicina – Universidade Federal do Rio Grande do Sul, Porto Alegre, RS – Brasil
| | - Regis Goulart Rosa
- Hospital Moinhos de VentoPorto AlegreRSBrasilProjetos de Pesquisa – Hospital Moinhos de Vento, Porto Alegre, RS – Brasil
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3
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Rosa RG, Cavalcanti AB, Azevedo LCP, Veiga VC, de Souza D, Dos Santos RDRM, Schardosim RFDC, Rech GS, Trott G, Schneider D, Robinson CC, Haubert TA, Pallaoro VEL, Brognoli LG, de Souza AP, Costa LS, Barroso BM, Pelliccioli MP, Gonzaga J, Studier NDS, Dagnino APA, Neto JDM, da Silva SS, Gimenes BDP, Dos Santos VB, Estivalete GPM, Pellegrino CDM, Polanczyk CA, Kawano-Dourado L, Tomazini BM, Lisboa TC, Teixeira C, Zampieri FG, Zavascki AP, Gersh BJ, Avezum Á, Machado FR, Berwanger O, Lopes RD, Falavigna M. Association between acute disease severity and one-year quality of life among post-hospitalisation COVID-19 patients: Coalition VII prospective cohort study. Intensive Care Med 2023; 49:166-177. [PMID: 36594987 PMCID: PMC9808680 DOI: 10.1007/s00134-022-06953-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/05/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess the association between acute disease severity and 1-year quality of life in patients discharged after hospitalisation due to coronavirus disease 2019 (COVID-19). METHODS We conducted a prospective cohort study nested in 5 randomised clinical trials between March 2020 and March 2022 at 84 sites in Brazil. Adult post-hospitalisation COVID-19 patients were followed for 1 year. The primary outcome was the utility score of EuroQol five-dimension three-level (EQ-5D-3L). Secondary outcomes included all-cause mortality, major cardiovascular events, and new disabilities in instrumental activities of daily living. Adjusted generalised estimating equations were used to assess the association between outcomes and acute disease severity according to the highest level on a modified ordinal scale during hospital stay (2: no oxygen therapy; 3: oxygen by mask or nasal prongs; 4: high-flow nasal cannula oxygen therapy or non-invasive ventilation; 5: mechanical ventilation). RESULTS 1508 COVID-19 survivors were enrolled. Primary outcome data were available for 1156 participants. At 1 year, compared with severity score 2, severity score 5 was associated with lower EQ-5D-3L utility scores (0.7 vs 0.84; adjusted difference, - 0.1 [95% CI - 0.15 to - 0.06]); and worse results for all-cause mortality (7.9% vs 1.2%; adjusted difference, 7.1% [95% CI 2.5%-11.8%]), major cardiovascular events (5.6% vs 2.3%; adjusted difference, 2.6% [95% CI 0.6%-4.6%]), and new disabilities (40.4% vs 23.5%; adjusted difference, 15.5% [95% CI 8.5%-22.5]). Severity scores 3 and 4 did not differ consistently from score 2. CONCLUSIONS COVID-19 patients who needed mechanical ventilation during hospitalisation have lower 1-year quality of life than COVID-19 patients who did not need mechanical ventilation during hospitalisation.
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Affiliation(s)
- Regis Goulart Rosa
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil. .,Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil. .,Research Unit, INOVA Medical, Porto Alegre, RS, Brazil.
| | - Alexandre Biasi Cavalcanti
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Hcor Research Institute, Hospital Do Coração, São Paulo, SP, Brazil
| | - Luciano César Pontes Azevedo
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Viviane Cordeiro Veiga
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,BP-A Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil
| | - Denise de Souza
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | | | | | - Gabriela Soares Rech
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Geraldine Trott
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Daniel Schneider
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Caroline Cabral Robinson
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Tainá Aparecida Haubert
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | | | - Liége Gregoletto Brognoli
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Ana Paula de Souza
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Lauren Sezerá Costa
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Bruna Machado Barroso
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | | | - Janine Gonzaga
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Nicole Dos Santos Studier
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | | | - Juliana de Mesquita Neto
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Sabrina Souza da Silva
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | - Bruna Dos Passos Gimenes
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil
| | | | | | | | - Carisi Anne Polanczyk
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil.,Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,National Institute for Health Technology Assessment, IATS/CNPq, Porto Alegre, RS, Brazil
| | | | - Bruno Martins Tomazini
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Hcor Research Institute, Hospital Do Coração, São Paulo, SP, Brazil.,Hospital Sírio-Libanês, São Paulo, SP, Brazil
| | - Thiago Costa Lisboa
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,PPG Ciências Pneumológicas UFRGS, Porto Alegre, RS, Brazil.,Intensive Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Cassiano Teixeira
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Intensive Care Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,UFCSPA Medical School, Porto Alegre, RS, Brazil
| | - Fernando Godinho Zampieri
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Hcor Research Institute, Hospital Do Coração, São Paulo, SP, Brazil.,Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Alexandre Prehn Zavascki
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil.,Infectious Diseases and Infection Control Service, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.,Internal Medicine Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Bernard J Gersh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Álvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - Flávia Ribeiro Machado
- Brazilian Research in Intensive Care Network (BRICNet), São Paulo, SP, Brazil.,Department of Anesthesiology, Pain and Intensive Care, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Otavio Berwanger
- Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Maicon Falavigna
- Hospital Moinhos de Vento, Rua Ramiro Barcelos, 630, 10º Andar, Sala 1007, Porto Alegre, RS, 90660-020, Brazil.,Research Unit, INOVA Medical, Porto Alegre, RS, Brazil.,National Institute for Health Technology Assessment, IATS/CNPq, Porto Alegre, RS, Brazil
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4
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Scolari FL, Trott G, Schneider D, Goldraich LA, Frederico Tonietto T, Moura LZ, Bertoldi EG, Rover MM, Wolf JM, Souza DD, Clausell N, Polanczyk CA, Rohde LE, Rosa RG, Wainstein RV. Cardiogenic shock treated with temporary mechanical circulatory support in Brazil: The effect of learning curve. Int J Artif Organs 2022; 45:292-300. [PMID: 35075937 DOI: 10.1177/03913988211070841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIMS Treatment with mechanical circulatory support (MCS) has been proposed to mitigate mortality in cardiogenic shock (CS). However, there is a lack of data on MCS programs implementation and the effect of the learning curve on its outcomes in limited resources countries such as Brazil. METHODS Prospective cohort of patients with CS admitted in four tertiary-care centers treated with Impella CP or veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Clinical outcomes were peri-procedural complications, short-term mortality rate, and the centers' learning curve. The cohort was divided into two periods: from April 2017 to July 2018 (n = 24), and from August 2018 to December 2020 (n = 25). RESULTS The study enrolled 49 patients [age 59 (43-63) years; 34 (70%) males]. The most common causes for CS were acute myocardial infarction in 22 (45%) and acute decompensation of chronic heart failure in 10 (20%). VA-ECMO was employed in 35 (71%) and Impella CP in 14 (29%) of patients. Overall complications occurred in 37 (76%) of patients, where major bleeding in 19 (38%) was the most common. The overall mortality rate was 61%, but it was lower in the second period (40%) in comparison to the first period (83%), p = 0.002. The learning curve analysis showed a decrease in the mortality rate after 40 consecutive cases. CONCLUSIONS Implementation of a temporary MCS program for refractory CS in a limited resource country is feasible. The learning curve effect might have played a role on survival rate since high morbimortality has decreased within time reaching optimal results by the end of the study.
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Affiliation(s)
- Fernando Luís Scolari
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.,Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Geraldine Trott
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel Schneider
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Livia Adams Goldraich
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tulio Frederico Tonietto
- Division of Critical Care Medicine, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lídia Zytynski Moura
- Transplant Division, Cardiology Department, Irmandade Hospital da Santa Casa de Misericórdia de Curitiba, Curitiba, Parana, Brazil
| | | | - Marciane Maria Rover
- Heart Failure and Transplant Division, Instituto de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jonas Michel Wolf
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Denise de Souza
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Nadine Clausell
- Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Carisi Anne Polanczyk
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.,Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luis Eduardo Rohde
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.,Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Regis Goulart Rosa
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Vugman Wainstein
- Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.,Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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5
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Rosa RG, Robinson CC, Veiga VC, Cavalcanti AB, Azevedo LCPD, Machado FR, Berwanger O, Avezum Á, Lopes RD, Lisboa TC, Teixeira C, Zampieri FG, Tomazini BM, Kawano-Dourado L, Schneider D, Souza DD, Santos RDRMD, Silva SSD, Trott G, Gimenes BDP, Souza APD, Barroso BM, Costa LS, Brognoli LG, Pelliccioli MP, Studier NDS, Schardosim RFDC, Haubert TA, Pallaoro VEL, Oliveira DMD, Velho PI, Medeiros GS, Gazzana MB, Zavascki AP, Pitrez PM, Oliveira RPD, Polanczyk CA, Nasi LA, Hammes LS, Falavigna M. Quality of life and long-term outcomes after hospitalization for COVID-19: Protocol for a prospective cohort study (Coalition VII). Rev Bras Ter Intensiva 2021; 33:31-37. [PMID: 33886851 PMCID: PMC8075344 DOI: 10.5935/0103-507x.20210003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/02/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION The long-term effects caused by COVID-19 are unknown. The present study aims to assess factors associated with health-related quality of life and long-term outcomes among survivors of hospitalization for COVID-19 in Brazil. METHODS This is a multicenter prospective cohort study nested in five randomized clinical trials designed to assess the effects of specific COVID-19 treatments in over 50 centers in Brazil. Adult survivors of hospitalization due to proven or suspected SARS-CoV-2 infection will be followed-up for a period of 1 year by means of structured telephone interviews. The primary outcome is the 1-year utility score of health-related quality of life assessed by the EuroQol-5D3L. Secondary outcomes include all-cause mortality, major cardiovascular events, rehospitalizations, return to work or study, physical functional status assessed by the Lawton-Brody Instrumental Activities of Daily Living, dyspnea assessed by the modified Medical Research Council dyspnea scale, need for long-term ventilatory support, symptoms of anxiety and depression assessed by the Hospital Anxiety and Depression Scale, symptoms of posttraumatic stress disorder assessed by the Impact of Event Scale-Revised, and self-rated health assessed by the EuroQol-5D3L Visual Analog Scale. Generalized estimated equations will be performed to test the association between five sets of variables (1- demographic characteristics, 2- premorbid state of health, 3- characteristics of acute illness, 4- specific COVID-19 treatments received, and 5- time-updated postdischarge variables) and outcomes. ETHICS AND DISSEMINATION The study protocol was approved by the Research Ethics Committee of all participant institutions. The results will be disseminated through conferences and peer-reviewed journals.
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Affiliation(s)
- Regis Goulart Rosa
- Hospital Moinhos de Vento - Porto Alegre (RS), Brasil.,Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil
| | | | - Viviane Cordeiro Veiga
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,BP - A Beneficência Portuguesa de São Paulo - São Paulo (SP), Brasil
| | - Alexandre Biasi Cavalcanti
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,Instituto de Pesquisa, HCor-Hospital do Coração - São Paulo (SP), Brasil
| | - Luciano César Pontes de Azevedo
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,Instituto de Educação e Pesquisa, Hospital Sírio-Libanês - São Paulo (SP), Brasil
| | - Flávia Ribeiro Machado
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,Departamento de Anestesiologia, Dor e Terapia Intensiva, Universidade Federal de São Paulo - São Paulo (SP), Brasil
| | - Otavio Berwanger
- Organização de Pesquisa Acadêmica, Hospital Israelita Albert Einstein - São Paulo (SP), Brasil
| | - Álvaro Avezum
- Centro Internacional de Pesquisa, Hospital Alemão Oswaldo Cruz - São Paulo (SP), Brasil
| | - Renato Delascio Lopes
- Brazilian Clinical Research Institute - São Paulo (SP), Brasil.,Instituto Duke de Pesquisa Clínica, Duke University Medical Center - Durham, NC, Estados Unidos
| | - Thiago Costa Lisboa
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,Instituto de Pesquisa, HCor-Hospital do Coração - São Paulo (SP), Brasil
| | - Cassiano Teixeira
- Hospital Moinhos de Vento - Porto Alegre (RS), Brasil.,Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil
| | - Fernando Godinho Zampieri
- Brazilian Research in Intensive Care Network (BRICNet) - São Paulo (SP), Brasil.,Instituto de Pesquisa, HCor-Hospital do Coração - São Paulo (SP), Brasil
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6
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Veiga VC, Prats JAGG, Farias DLC, Rosa RG, Dourado LK, Zampieri FG, Machado FR, Lopes RD, Berwanger O, Azevedo LCP, Avezum Á, Lisboa TC, Rojas SSO, Coelho JC, Leite RT, Carvalho JC, Andrade LEC, Sandes AF, Pintão MCT, Castro CG, Santos SV, de Almeida TML, Costa AN, Gebara OCE, de Freitas FGR, Pacheco ES, Machado DJB, Martin J, Conceição FG, Siqueira SRR, Damiani LP, Ishihara LM, Schneider D, de Souza D, Cavalcanti AB, Scheinberg P. Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial. BMJ 2021; 372:n84. [PMID: 33472855 PMCID: PMC7815251 DOI: 10.1136/bmj.n84] [Citation(s) in RCA: 254] [Impact Index Per Article: 84.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine whether tocilizumab improves clinical outcomes for patients with severe or critical coronavirus disease 2019 (covid-19). DESIGN Randomised, open label trial. SETTING Nine hospitals in Brazil, 8 May to 17 July 2020. PARTICIPANTS Adults with confirmed covid-19 who were receiving supplemental oxygen or mechanical ventilation and had abnormal levels of at least two serum biomarkers (C reactive protein, D dimer, lactate dehydrogenase, or ferritin). The data monitoring committee recommended stopping the trial early, after 129 patients had been enrolled, because of an increased number of deaths at 15 days in the tocilizumab group. INTERVENTIONS Tocilizumab (single intravenous infusion of 8 mg/kg) plus standard care (n=65) versus standard care alone (n=64). MAIN OUTCOME MEASURE The primary outcome, clinical status measured at 15 days using a seven level ordinal scale, was analysed as a composite of death or mechanical ventilation because the assumption of odds proportionality was not met. RESULTS A total of 129 patients were enrolled (mean age 57 (SD 14) years; 68% men) and all completed follow-up. All patients in the tocilizumab group and two in the standard care group received tocilizumab. 18 of 65 (28%) patients in the tocilizumab group and 13 of 64 (20%) in the standard care group were receiving mechanical ventilation or died at day 15 (odds ratio 1.54, 95% confidence interval 0.66 to 3.66; P=0.32). Death at 15 days occurred in 11 (17%) patients in the tocilizumab group compared with 2 (3%) in the standard care group (odds ratio 6.42, 95% confidence interval 1.59 to 43.2). Adverse events were reported in 29 of 67 (43%) patients who received tocilizumab and 21 of 62 (34%) who did not receive tocilizumab. CONCLUSIONS In patients with severe or critical covid-19, tocilizumab plus standard care was not superior to standard care alone in improving clinical outcomes at 15 days, and it might increase mortality. TRIAL REGISTRATION ClinicalTrials.gov NCT04403685.
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Affiliation(s)
- Viviane C Veiga
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
| | - João A G G Prats
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Danielle L C Farias
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Regis G Rosa
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | | | - Fernando G Zampieri
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- HCor Research Institute, São Paulo, Brazil
| | - Flávia R Machado
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- Anesthesiology, Pain and Intensive Care Department, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Renato D Lopes
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
- Brazilian Clinical Research Institute, São Paulo, Brazil
| | - Otavio Berwanger
- Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Luciano C P Azevedo
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Álvaro Avezum
- International Research Center-Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Thiago C Lisboa
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- HCor Research Institute, São Paulo, Brazil
| | - Salomón S O Rojas
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Juliana C Coelho
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Rodrigo T Leite
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Júlio C Carvalho
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
| | - Luis E C Andrade
- Fleury Medicine and Health Laboratories, Grupo Fleury, São Paulo, Brazil
| | - Alex F Sandes
- Fleury Medicine and Health Laboratories, Grupo Fleury, São Paulo, Brazil
| | - Maria C T Pintão
- Fleury Medicine and Health Laboratories, Grupo Fleury, São Paulo, Brazil
| | - Claudio G Castro
- Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | | | - Thiago M L de Almeida
- Anesthesiology, Pain and Intensive Care Department, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | - Lucas P Damiani
- HCor Research Institute, São Paulo, Brazil
- Estátikos Consultoria Estatística, São Paulo, Brazil
| | | | | | | | - Alexandre B Cavalcanti
- Brazilian Research in Intensive Care Network-BRICNet, São Paulo, Brazil
- HCor Research Institute, São Paulo, Brazil
| | - Phillip Scheinberg
- BP-A Beneficência Portuguesa de São Paulo, Rua Maestro Cardim, 769-Bela Vista, São Paulo-SP, 01323-001, Brazil
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7
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Robinson CC, Rosa RG, Kochhann R, Schneider D, Sganzerla D, Dietrich C, Sanchez ÉC, Dutra FH, Oliveira MQD, Anzolin LB, Menezes SFD, Jeffman R, Souza DD, Silva SFD, Cruz LN, Boldo R, Cardoso JR, Birriel DC, Gamboa MN, Machado AS, Andrade JMSD, Alencar C, Teixeira MC, Vieira SRR, Moreira FC, Amaral A, Silveira APM, Teles JMM, Oliveira DCD, Oliveira Júnior LCD, Castro LCE, Silva MSD, Neves RT, Gomes RDA, Ribeiro CM, Cavalcanti AB, Oliveira RPD, Maccari JG, Berto PP, Martins LA, Santos RLDS, Ue LY, Hammes LS, Sharshar T, Bozza F, Falavigna M, Teixeira C. Quality of life after intensive care unit: a multicenter cohort study protocol for assessment of long-term outcomes among intensive care survivors in Brazil. Rev Bras Ter Intensiva 2019; 30:405-413. [PMID: 30652780 PMCID: PMC6334490 DOI: 10.5935/0103-507x.20180063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/30/2018] [Indexed: 01/04/2023] Open
Abstract
Objective To establish the prevalence of physical, cognitive and psychiatric
disabilities, associated factors and their relationship with the qualities
of life of intensive care survivors in Brazil. Methods A prospective multicenter cohort study is currently being conducted at 10
adult medical-surgical intensive care units representative of the 5
Brazilian geopolitical regions. Patients aged ≥ 18 years who are
discharged from the participating intensive care units and stay 72 hours or
more in the intensive care unit for medical or emergency surgery admissions
or 120 hours or more for elective surgery admissions are consecutively
included. Patients are followed up for a period of one year by means of
structured telephone interviews conducted at 3, 6 and 12 months after
discharge from the intensive care unit. The outcomes are functional
dependence, cognitive dysfunction, anxiety and depression symptoms,
posttraumatic stress symptoms, health-related quality of life,
rehospitalization and long-term mortality. Discussion The present study has the potential to contribute to current knowledge of the
prevalence and factors associated with postintensive care syndrome among
adult intensive care survivors in Brazil. In addition, an association might
be established between postintensive care syndrome and health-related
quality of life.
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Affiliation(s)
- Caroline Cabral Robinson
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Regis Goulart Rosa
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil.,Centro de Tratamento Intensivo Adulto, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Renata Kochhann
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Daniel Schneider
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Daniel Sganzerla
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Camila Dietrich
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Évelin Carneiro Sanchez
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Francine Hoffmann Dutra
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Maicon Quadro de Oliveira
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Luisa Barbosa Anzolin
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Suelen Fardim de Menezes
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Rodrigo Jeffman
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Denise de Souza
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Sâmia Faria da Silva
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Luciane Nascimento Cruz
- Escritório de Projetos Programa de Apoio ao Desenvolvimento Institucional/Sistema Único de Saúde (PROADI-SUS), Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Rodrigo Boldo
- Unidade de Tratamento Intensivo, Hospital Santa Clara, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil
| | - Juliana Rezende Cardoso
- Unidade de Tratamento Intensivo, Hospital Santa Clara, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil
| | - Daniella Cunha Birriel
- Unidade de Tratamento Intensivo, Pavilhão Pereira Filho, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil
| | - Mariana Nunes Gamboa
- Unidade de Tratamento Intensivo, Pavilhão Pereira Filho, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil
| | | | | | - Cesar Alencar
- Centro de Tratamento Intensivo, Hospital Conceição, Grupo Hospitalar Conceição - Porto Alegre (RS), Brasil
| | - Michelle Carneiro Teixeira
- Centro de Tratamento Intensivo, Hospital Conceição, Grupo Hospitalar Conceição - Porto Alegre (RS), Brasil
| | - Silvia Regina Rios Vieira
- Centro de Tratamento Intensivo, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Fernanda Caleffe Moreira
- Centro de Tratamento Intensivo, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Alexandre Amaral
- Unidade de Tratamento Intensivo, Hospital de Urgências de Goiânia - Goiânia (GO), Brasil
| | | | - José Mario Meira Teles
- Unidade de Tratamento Intensivo, Hospital de Urgências de Goiânia - Goiânia (GO), Brasil
| | | | | | - Lívia Correa E Castro
- Unidade de Tratamento Intensivo, Hospital Regional do Baixo Amazonas - Santarém (PA), Brasil
| | - Marli Sarmento da Silva
- Unidade de Tratamento Intensivo, Hospital Regional do Baixo Amazonas - Santarém (PA), Brasil
| | | | | | | | | | | | | | - Paula Pinheiro Berto
- Centro de Tratamento Intensivo, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil
| | - Lucieda Araújo Martins
- Coordenação Geral de Atenção Hospitalar, Departamento de Atenção Hospitalar e de Urgência, Secretaria de Atenção à Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Rui Leandro da Silva Santos
- Coordenação Geral de Atenção Hospitalar, Departamento de Atenção Hospitalar e de Urgência, Secretaria de Atenção à Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Luciana Yumi Ue
- Coordenação Geral de Atenção Hospitalar, Departamento de Atenção Hospitalar e de Urgência, Secretaria de Atenção à Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Luciano Serpa Hammes
- Superintendência de Educação, Pesquisa e Responsabilidade Social, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Tarek Sharshar
- Department of Histopathology and Animal Models, Institute Pasteur - Paris, France.,General Intensive Care, Assistance Publique Hôpitaux de Paris, Raymond Poincaré Hospital, University of Versailles Saint-Quentin en Yvelines - Paris, France
| | - Fernando Bozza
- Instituto D'Or de Pesquisa e Ensino - Rio de Janeiro (RJ), Brasil
| | - Maicon Falavigna
- Centro de Tratamento Intensivo Adulto, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
| | - Cassiano Teixeira
- Centro de Tratamento Intensivo Adulto, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil
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