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In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil

BACKGROUND: We evaluated in-hospital mortality and outcomes incidence after hospital discharge due to COVID-19 in a Brazilian multicenter cohort. METHODS: This prospective multicenter study (RECOVER-SUS, NCT04807699) included COVID-19 patients hospitalized in public tertiary hospitals in Brazil from...

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Autores principales: Perazzo, Hugo, Cardoso, Sandra W., Ribeiro, Maria Pia D., Moreira, Rodrigo, Coelho, Lara E., Jalil, Emilia M., Japiassú, André Miguel, Gouvêa, Elias Pimentel, Nunes, Estevão Portela, Andrade, Hugo Boechat, Gouvêa, Luciano Barros, Ferreira, Marcel Treptow, Rodrigues, Pedro Mendes de Azambuja, Moreira, Ronaldo, Geraldo, Kim, Freitas, Lucilene, Pacheco, Vinicius V., João, Esau Custódio, Fuller, Trevon, Rocha, Verônica Diniz, Nunes, Ceuci de Lima Xavier, Souza, Tâmara Newman Lobato, Toscano, Ana Luiza Castro Conde, Schwarzbold, Alexandre Vargas, Noal, Helena Carolina, Pinto, Gustavo de Araujo, Lemos, Paula Macedo de Oliveira, Santos, Carla, Mello, Fernanda Carvalho de Queiroz, Veloso, Valdilea G., Grinsztejn, Beatriz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001143/
https://www.ncbi.nlm.nih.gov/pubmed/35434696
http://dx.doi.org/10.1016/j.lana.2022.100244
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author Perazzo, Hugo
Cardoso, Sandra W.
Ribeiro, Maria Pia D.
Moreira, Rodrigo
Coelho, Lara E.
Jalil, Emilia M.
Japiassú, André Miguel
Gouvêa, Elias Pimentel
Nunes, Estevão Portela
Andrade, Hugo Boechat
Gouvêa, Luciano Barros
Ferreira, Marcel Treptow
Rodrigues, Pedro Mendes de Azambuja
Moreira, Ronaldo
Geraldo, Kim
Freitas, Lucilene
Pacheco, Vinicius V.
João, Esau Custódio
Fuller, Trevon
Rocha, Verônica Diniz
Nunes, Ceuci de Lima Xavier
Souza, Tâmara Newman Lobato
Toscano, Ana Luiza Castro Conde
Schwarzbold, Alexandre Vargas
Noal, Helena Carolina
Pinto, Gustavo de Araujo
Lemos, Paula Macedo de Oliveira
Santos, Carla
Mello, Fernanda Carvalho de Queiroz
Veloso, Valdilea G.
Grinsztejn, Beatriz
author_facet Perazzo, Hugo
Cardoso, Sandra W.
Ribeiro, Maria Pia D.
Moreira, Rodrigo
Coelho, Lara E.
Jalil, Emilia M.
Japiassú, André Miguel
Gouvêa, Elias Pimentel
Nunes, Estevão Portela
Andrade, Hugo Boechat
Gouvêa, Luciano Barros
Ferreira, Marcel Treptow
Rodrigues, Pedro Mendes de Azambuja
Moreira, Ronaldo
Geraldo, Kim
Freitas, Lucilene
Pacheco, Vinicius V.
João, Esau Custódio
Fuller, Trevon
Rocha, Verônica Diniz
Nunes, Ceuci de Lima Xavier
Souza, Tâmara Newman Lobato
Toscano, Ana Luiza Castro Conde
Schwarzbold, Alexandre Vargas
Noal, Helena Carolina
Pinto, Gustavo de Araujo
Lemos, Paula Macedo de Oliveira
Santos, Carla
Mello, Fernanda Carvalho de Queiroz
Veloso, Valdilea G.
Grinsztejn, Beatriz
author_sort Perazzo, Hugo
collection PubMed
description BACKGROUND: We evaluated in-hospital mortality and outcomes incidence after hospital discharge due to COVID-19 in a Brazilian multicenter cohort. METHODS: This prospective multicenter study (RECOVER-SUS, NCT04807699) included COVID-19 patients hospitalized in public tertiary hospitals in Brazil from June 2020 to March 2021. Clinical assessment and blood samples were performed at hospital admission, with post-hospital discharge remote visits. Hospitalized participants were followed-up until March 31, 2021. The outcomes were in-hospital mortality and incidence of rehospitalization or death after hospital discharge. Kaplan–Meier curves and Cox proportional-hazard models were performed. FINDINGS: 1589 participants [54.5% male, age=62 (IQR 50-70) years; BMI=28.4 (IQR,24.9–32.9) Kg/m² and 51.9% with diabetes] were included. A total of 429 individuals [27.0% (95%CI,24.8–29.2)] died during hospitalization (median time 14 (IQR,9–24) days). Older age [vs<40 years; age=60–69 years-aHR=1.89 (95%CI,1.08–3.32); age=70–79 years-aHR=2.52 (95%CI,1.42–4.45); age≥80-aHR=2.90 (95%CI 1.54–5.47)]; noninvasive or mechanical ventilation at admission [vs facial-mask or none; aHR=1.69 (95%CI 1.30–2.19)]; SAPS-III score≥57 [vs<57; aHR=1.47 (95%CI 1.13–1.92)] and SOFA score≥10 [vs <10; aHR=1.51 (95%CI 1.08–2.10)] were independently associated with in-hospital mortality. A total of 65 individuals [6.7% (95%CI 5.3–8.4)] had a rehospitalization or death [rate=323 (95%CI 250–417) per 1000 person-years] in a median time of 52 (range 1–280) days post-hospital discharge. Age ≥ 60 years [vs <60, aHR=2.13 (95%CI 1.15–3.94)] and SAPS-III ≥57 at admission [vs <57, aHR=2.37 (95%CI 1.22–4.59)] were independently associated with rehospitalization or death after hospital discharge. INTERPRETATION: High in-hospital mortality rates due to COVID-19 were observed and elderly people remained at high risk of rehospitalization and death after hospital discharge. FUNDING: Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Programa INOVA-FIOCRUZ.
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spelling pubmed-90011432022-04-12 In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil Perazzo, Hugo Cardoso, Sandra W. Ribeiro, Maria Pia D. Moreira, Rodrigo Coelho, Lara E. Jalil, Emilia M. Japiassú, André Miguel Gouvêa, Elias Pimentel Nunes, Estevão Portela Andrade, Hugo Boechat Gouvêa, Luciano Barros Ferreira, Marcel Treptow Rodrigues, Pedro Mendes de Azambuja Moreira, Ronaldo Geraldo, Kim Freitas, Lucilene Pacheco, Vinicius V. João, Esau Custódio Fuller, Trevon Rocha, Verônica Diniz Nunes, Ceuci de Lima Xavier Souza, Tâmara Newman Lobato Toscano, Ana Luiza Castro Conde Schwarzbold, Alexandre Vargas Noal, Helena Carolina Pinto, Gustavo de Araujo Lemos, Paula Macedo de Oliveira Santos, Carla Mello, Fernanda Carvalho de Queiroz Veloso, Valdilea G. Grinsztejn, Beatriz Lancet Reg Health Am Articles BACKGROUND: We evaluated in-hospital mortality and outcomes incidence after hospital discharge due to COVID-19 in a Brazilian multicenter cohort. METHODS: This prospective multicenter study (RECOVER-SUS, NCT04807699) included COVID-19 patients hospitalized in public tertiary hospitals in Brazil from June 2020 to March 2021. Clinical assessment and blood samples were performed at hospital admission, with post-hospital discharge remote visits. Hospitalized participants were followed-up until March 31, 2021. The outcomes were in-hospital mortality and incidence of rehospitalization or death after hospital discharge. Kaplan–Meier curves and Cox proportional-hazard models were performed. FINDINGS: 1589 participants [54.5% male, age=62 (IQR 50-70) years; BMI=28.4 (IQR,24.9–32.9) Kg/m² and 51.9% with diabetes] were included. A total of 429 individuals [27.0% (95%CI,24.8–29.2)] died during hospitalization (median time 14 (IQR,9–24) days). Older age [vs<40 years; age=60–69 years-aHR=1.89 (95%CI,1.08–3.32); age=70–79 years-aHR=2.52 (95%CI,1.42–4.45); age≥80-aHR=2.90 (95%CI 1.54–5.47)]; noninvasive or mechanical ventilation at admission [vs facial-mask or none; aHR=1.69 (95%CI 1.30–2.19)]; SAPS-III score≥57 [vs<57; aHR=1.47 (95%CI 1.13–1.92)] and SOFA score≥10 [vs <10; aHR=1.51 (95%CI 1.08–2.10)] were independently associated with in-hospital mortality. A total of 65 individuals [6.7% (95%CI 5.3–8.4)] had a rehospitalization or death [rate=323 (95%CI 250–417) per 1000 person-years] in a median time of 52 (range 1–280) days post-hospital discharge. Age ≥ 60 years [vs <60, aHR=2.13 (95%CI 1.15–3.94)] and SAPS-III ≥57 at admission [vs <57, aHR=2.37 (95%CI 1.22–4.59)] were independently associated with rehospitalization or death after hospital discharge. INTERPRETATION: High in-hospital mortality rates due to COVID-19 were observed and elderly people remained at high risk of rehospitalization and death after hospital discharge. FUNDING: Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Programa INOVA-FIOCRUZ. Elsevier 2022-04-12 /pmc/articles/PMC9001143/ /pubmed/35434696 http://dx.doi.org/10.1016/j.lana.2022.100244 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Articles
Perazzo, Hugo
Cardoso, Sandra W.
Ribeiro, Maria Pia D.
Moreira, Rodrigo
Coelho, Lara E.
Jalil, Emilia M.
Japiassú, André Miguel
Gouvêa, Elias Pimentel
Nunes, Estevão Portela
Andrade, Hugo Boechat
Gouvêa, Luciano Barros
Ferreira, Marcel Treptow
Rodrigues, Pedro Mendes de Azambuja
Moreira, Ronaldo
Geraldo, Kim
Freitas, Lucilene
Pacheco, Vinicius V.
João, Esau Custódio
Fuller, Trevon
Rocha, Verônica Diniz
Nunes, Ceuci de Lima Xavier
Souza, Tâmara Newman Lobato
Toscano, Ana Luiza Castro Conde
Schwarzbold, Alexandre Vargas
Noal, Helena Carolina
Pinto, Gustavo de Araujo
Lemos, Paula Macedo de Oliveira
Santos, Carla
Mello, Fernanda Carvalho de Queiroz
Veloso, Valdilea G.
Grinsztejn, Beatriz
In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title_full In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title_fullStr In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title_full_unstemmed In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title_short In-hospital mortality and severe outcomes after hospital discharge due to COVID-19: A prospective multicenter study from Brazil
title_sort in-hospital mortality and severe outcomes after hospital discharge due to covid-19: a prospective multicenter study from brazil
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001143/
https://www.ncbi.nlm.nih.gov/pubmed/35434696
http://dx.doi.org/10.1016/j.lana.2022.100244
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