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Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?

The Coronavirus Disease 2019 (COVID-19) pandemic posed various challenges to the healthcare system and disease management. This study aimed to describe changes in the clinical characteristics and outcomes of hospitalized patients during the first year of the COVID-19 pandemic in a city in southern B...

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Autores principales: Demeneck, Henrique, Luiz Parmegiani de Oliveira, André, do Carmo Machado Kneipp Lopes, Julia, Ryoiti Matsunago, Leonardo, Cavalca Grupenmacher, Luiza, Roberto Curcio Pereira, Marcos, Benício Stocco, Rebecca, Ali El Chab Parolin, Salma, Olandoski, Marcia, Pellegrino Baena, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234546/
https://www.ncbi.nlm.nih.gov/pubmed/37262056
http://dx.doi.org/10.1371/journal.pone.0286589
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author Demeneck, Henrique
Luiz Parmegiani de Oliveira, André
do Carmo Machado Kneipp Lopes, Julia
Ryoiti Matsunago, Leonardo
Cavalca Grupenmacher, Luiza
Roberto Curcio Pereira, Marcos
Benício Stocco, Rebecca
Ali El Chab Parolin, Salma
Olandoski, Marcia
Pellegrino Baena, Cristina
author_facet Demeneck, Henrique
Luiz Parmegiani de Oliveira, André
do Carmo Machado Kneipp Lopes, Julia
Ryoiti Matsunago, Leonardo
Cavalca Grupenmacher, Luiza
Roberto Curcio Pereira, Marcos
Benício Stocco, Rebecca
Ali El Chab Parolin, Salma
Olandoski, Marcia
Pellegrino Baena, Cristina
author_sort Demeneck, Henrique
collection PubMed
description The Coronavirus Disease 2019 (COVID-19) pandemic posed various challenges to the healthcare system and disease management. This study aimed to describe changes in the clinical characteristics and outcomes of hospitalized patients during the first year of the COVID-19 pandemic in a city in southern Brazil. This prospective study was carried out in two tertiary care private hospitals in Curitiba. A total of 1151 patients hospitalized between March 2020 and March 2021 were included. We identified three epidemiological critical periods of the pandemic and compared patients’ characteristics and the frequencies of oral intubation, intensive care unit (ICU) admission and mortality. Continuous variables were analyzed by variance analysis model (ANOVA) or the Kruskal–Wallis nonparametric test and categorical variables by the chi-square or Fisher’s exact test. Models for univariate and multivariate logistic regression analysis were adjusted to identify the factors associated with mortality. All p-values were two-tailed and p<0.05 was considered statistically significant. The average age of the patients was 58 years and 60.9% (n = 701) were males. The most prevalent comorbidities were systemic arterial hypertension, diabetes and obesity. There were no significant variations in the demographic characteristics and previous comorbidities of the patients for the different periods of analysis. Mortality was positively associated with the age ≥65 years and the presence of one or more cardiometabolic comorbidities (p<0.001). March 2021 was the most important critical period of the pandemic since there were higher frequencies of patients admitted later in the course of the disease, with desaturation and more symptoms at hospital admission (p<0.001). There was also an increase in the duration of hospital stay (p<0.001) and the frequencies of all critical outcomes for this period: oral intubation (p<0.001), ICU admission (p = 0.606) and mortality (p = 0.001). Our key findings revealed that, although there were no statistically significant differences between the subgroups of hospitalized patients over time in terms of demographic characteristics and comorbidities, the course of COVID-19 was significantly more severe for patients admitted to the hospital at the end of the first year of the pandemic in Brazil.
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spelling pubmed-102345462023-06-02 Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic? Demeneck, Henrique Luiz Parmegiani de Oliveira, André do Carmo Machado Kneipp Lopes, Julia Ryoiti Matsunago, Leonardo Cavalca Grupenmacher, Luiza Roberto Curcio Pereira, Marcos Benício Stocco, Rebecca Ali El Chab Parolin, Salma Olandoski, Marcia Pellegrino Baena, Cristina PLoS One Research Article The Coronavirus Disease 2019 (COVID-19) pandemic posed various challenges to the healthcare system and disease management. This study aimed to describe changes in the clinical characteristics and outcomes of hospitalized patients during the first year of the COVID-19 pandemic in a city in southern Brazil. This prospective study was carried out in two tertiary care private hospitals in Curitiba. A total of 1151 patients hospitalized between March 2020 and March 2021 were included. We identified three epidemiological critical periods of the pandemic and compared patients’ characteristics and the frequencies of oral intubation, intensive care unit (ICU) admission and mortality. Continuous variables were analyzed by variance analysis model (ANOVA) or the Kruskal–Wallis nonparametric test and categorical variables by the chi-square or Fisher’s exact test. Models for univariate and multivariate logistic regression analysis were adjusted to identify the factors associated with mortality. All p-values were two-tailed and p<0.05 was considered statistically significant. The average age of the patients was 58 years and 60.9% (n = 701) were males. The most prevalent comorbidities were systemic arterial hypertension, diabetes and obesity. There were no significant variations in the demographic characteristics and previous comorbidities of the patients for the different periods of analysis. Mortality was positively associated with the age ≥65 years and the presence of one or more cardiometabolic comorbidities (p<0.001). March 2021 was the most important critical period of the pandemic since there were higher frequencies of patients admitted later in the course of the disease, with desaturation and more symptoms at hospital admission (p<0.001). There was also an increase in the duration of hospital stay (p<0.001) and the frequencies of all critical outcomes for this period: oral intubation (p<0.001), ICU admission (p = 0.606) and mortality (p = 0.001). Our key findings revealed that, although there were no statistically significant differences between the subgroups of hospitalized patients over time in terms of demographic characteristics and comorbidities, the course of COVID-19 was significantly more severe for patients admitted to the hospital at the end of the first year of the pandemic in Brazil. Public Library of Science 2023-06-01 /pmc/articles/PMC10234546/ /pubmed/37262056 http://dx.doi.org/10.1371/journal.pone.0286589 Text en © 2023 Demeneck et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Demeneck, Henrique
Luiz Parmegiani de Oliveira, André
do Carmo Machado Kneipp Lopes, Julia
Ryoiti Matsunago, Leonardo
Cavalca Grupenmacher, Luiza
Roberto Curcio Pereira, Marcos
Benício Stocco, Rebecca
Ali El Chab Parolin, Salma
Olandoski, Marcia
Pellegrino Baena, Cristina
Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title_full Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title_fullStr Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title_full_unstemmed Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title_short Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?
title_sort clinical characteristics and outcomes of hospitalized patients with covid-19 in a city of south brazil: have they changed through the first year of the pandemic?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234546/
https://www.ncbi.nlm.nih.gov/pubmed/37262056
http://dx.doi.org/10.1371/journal.pone.0286589
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