JULIANA CARVALHO FERREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cardio-Pneumologia, Faculdade de Medicina - Docente
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
44 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 44
- Brazilian recommendations of mechanical ventilation 2013. Part 1(2014) CAVALCANTI, Alexandre Biasi; ISOLA, Alexandre Marini; GAMA, Ana Maria Casati; DUARTE, Antonio Carlos Magalhaes; VIANNA, Arthur; SERPA NETO, Ary; FARIAS, Augusto Manoel de Carvalho; BRAVIM, Bruno de Arruda; PINHEIRO, Bruno do Valle; MAZZA, Bruno Franco; CARVALHO, Carlos Roberto Ribeiro de; TOUFEN JUNIOR, Carlos; BARBAS, Carmen Silvia Valente; DAVID, Cid Marcos Nascimento; TANIGUCHI, Corine; MAZZA, Debora Dutra da Silveira; DRAGOSAVAC, Desanka; TOLEDO, Diogo Oliveira; COSTA, Eduardo Leite; CASER, Eliana Bemardete; SILVA, Eliezer; AMORIM, Fabio Ferreira; SADDY, Felipe; GALAS, Filomena Regina Barbosa Gomes; SILVA, Gisele Sampaio; MATOS, Gustavo Faissol Janot de; EMMERICH, Joao Claudio; VALIATTI, Jorge Luis dos Sanots; TELES, Jose Mario Vleira; VICTORINO, Josue Almeida; FERREIRA, Juliana Carvalho; PRODOMO, Luciana Passuello do Vale; HAJAR, Ludhmila Abrahao; MARTINS, Luiz Claudio; MALBOUISSON, Luiz Marcelo Sa; VARGAS, Mara Ambrosina de Oliveira; HOLANDA, Marcelo Alcantara; AMATO, Marcelo Brito Passos; PARK, Marcelo; JACOMELLI, Marcia; REIS, Marco Antonio Soares; TAVARES, Marcos; DAMASCENO, Marta Cristina Paulette; DAMASCENO, Moyzes Pinto Coelho Duarte; ASSUNCAO, Murillo Santucci Cesar; YOUSSEF, Nazah Cherif Mohamad; MESSEDER, Octavio; TEIXEIRA, Paulo Jose Zimmermann; CARUSO, Pedro; DUARTE, Pericles Almeida Delfino; EID, Raquel Caserta; RODRIGUES, Ricardo Goulart; JESUS, Rodrigo Francisco de; KAIRALLA, Ronald Adib; JUSTINO, Sandra; NEMER, Sergio Nogueira; ROMERO, Simone Barbosa; AMADO, Veronica MoreiraPerspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associacao de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in Sao Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.
- Simulation-based Assessment to Measure Proficiency in Mechanical Ventilation among Residents(2022) HAYASHI, Fatima K.; SOUSA, Mayson L. A.; GARCIA, Marcos V. F.; MACEDO, Bruno R.; FERREIRA, Juliana C.Background: Mechanical ventilation (MV) skills are essential for clinicians caring for critically ill patients, yet few training programs use structured curricula and appropriate assessments. Objective structured clinical exams (OSCEs) have been used to assess clinical competency in many areas, but there are no OSCE models focused on MV. Objective: To develop and validate a simulation-based assessment (SBA) with an OSCE structure to assess baseline MV competence among residents and identify knowledge gaps. Methods: We developed an SBA using a lung simulator and a mechanical ventilator, and an OSCE structure, with six clinical scenarios in MV. We included internal medicine residents at the beginning of their rotation in the respiratory intensive care unit (ICU) of a university-affiliated hospital. A subset of residents was also evaluated with a validated multiple-choice exam (MCE) at the beginning and at the end of the ICU rotation. Scores on both assessments were normalized to range from 0 to 10. We used Cronbach's a coefficient to assess reliability and Spearman correlation to estimate the correlation between the SBA and the MCE. Results: We included 80 residents, of whom 42 also completed the MCE examinations. The final version of the SBA had 32 items, and the Cronbach's a coefficient was 0.72 (95% confidence interval [CI], 0.64-0.81). The average SBA score was 6.2 +/- 1.3, and performance was variable across items, with 80% correctly adjusting initial ventilatory settings and only 12% correctly identifying asynchrony. The MCE had 24 questions, and the average score was 7.6 +/- 2.4 at the beginning of the rotation and 8.2 +/- 2.3 at the end of the rotation (increase of 0.6 points; 95% CI, 0.30-0.90; P < 0.001). There was moderate correlation between the SBA and the MCE (rho = 0.41; P = 0.002). Conclusion: We developed and validated an objective structured assessment on MV using a pulmonary simulator and a mechanical ventilator addressing the main competencies in MV. The performance of residents in the SBA at the beginning of an ICU rotation was lower than the performance in MCE, highlighting the need for greater emphasis on practical skills in MV during residency.
- Patient-ventilator asynchrony(2018) HOLANDA, Marcelo Alcantara; VASCONCELOS, Renata dos Santos; FERREIRA, Juliana Carvalho; PINHEIRO, Bruno ValleA assincronia pacie nte-ventilador (APV) é um desacoplamento entre o paciente, em relação a demandas de tempo, fluxo, volume e/ou pressão de seu sistema respiratório, e o ventilador, que as oferta durante a ventilação mecânica (VM). É um fenômeno comum, com taxas de incidência entre 10% e 85%. A APV pode ser devida a fatores relacionados ao paciente, ao ventilador ou a ambos. Os tipos de APV mais comuns são as de disparo, como esforço ineficaz; autodisparo e duplo disparo; as de ciclagem (tanto prematura quanto tardia); e as de fluxo (insuficiente ou excessivo). Cada um desses tipos pode ser detectado pela inspeção visual das curvas de volume-tempo, fluxo-tempo e pressãotempo na tela do ventilador mecânico. Estratégias ventilatórias específicas podem ser adotadas, em combinação com a abordagem clínica do paciente, como controle de dor, ansiedade, febre, etc. Níveis profundos de sedação devem ser evitados sempre que possível. A APV se associa a desfechos indesejados, tais como desconforto, dispneia, piora da troca gasosa, aumento do trabalho da respiração, lesão muscular diafragmática, prejuízo do sono, aumento da necessidade de sedação e/ou de bloqueio neuromuscular, assim como aumento do tempo de VM, de desmame e de mortalidade. A ventilação proporcional assistida e a ventilação assistida com ajuste neural são modalidades de suporte ventilatório parcial que reduzem a APV e têm se mostrado promissoras. Este artigo revisa a literatura acerca da APV abordando seus tipos, causas, métodos de avaliação, suas potenciais implicações no processo de recuperação de pacientes críticos e estratégias para sua resolução.
- Brazilian recommendations of mechanical ventilation 2013. Part 2(2014) CAVALCANTI, Alexandre Biasi; ISOLA, Alexandre Marini; GAMA, Ana Maria Casati; DUARTE, Antonio Carlos Magalhaes; VIANNA, Arthur; SERPA NETO, Ary; FARIAS, Augusto Manoel de Carvalho; BRAVIM, Bruno de Arruda; PINHEIRO, Bruno do Valle; MAZZA, Bruno Franco; CARVALHO, Carlos Roberto Ribeiro de; TOUFEN JUNIOR, Carlos; BARBAS, Carmen Silvia Valente; DAVID, Cid Marcos Nascimento; TANIGUCHI, Corine; MAZZA, Debora Dutra da Silveira; DRAGOSAVAC, Desanka; TOLEDO, Diogo Oliveira; COSTA, Eduardo Leite; CASER, Eliana Bernardete; SILVA, Eliezer; AMORIM, Fabio Ferreira; SADDY, Felipe; GALAS, Filomena Regina Barbosa Gomes; SILVA, Gisele Sampaio; MATOS, Gustavo Faissol Janot de; EMMERICH, Joao Claudio; VALIATTI, Jorge Luis dos Sanots; TELES, Jose Mario Meira; VICTORINO, Josue Almeida; FERREIRA, Juliana Carvalho; PRODOMO, Luciana Passuello do Vale; HAJJAR, Ludhmila Abrahao; MARTINS, Luiz Claudio; MALBOUISSON, Luiz Marcelo Sa; VARGAS, Mara Ambrosina de Oliveira; HOLANDA, Marcelo Alcantara; AMATO, Marcelo Brito Passos; PARK, Marcelo; JACOMELLI, Marcia; REIS, Marco Antonio Soares; TAVARES, Marcos; DAMASCENO, Marta Cristina Paulette; DAMASCENO, Moyzes Pinto Coelho Duarte; ASSUNCAO, Murillo Santucci Cesar; YOUSSEF, Nazah Cherif Mohamad; MESSEDER, Octavio; TEIXEIRA, Paulo Jose Zimmermann; CARUSO, Pedro; DUARTE, Pericles Almeida Delfino; EID, Raquel Caserta; RODRIGUES, Ricardo Goulart; JESUS, Rodrigo Francisco de; KAIRALLA, Ronaldo Adib; JUSTINO, Sandra; NEMER, Sergio Nogueira; ROMERO, Simone Barbosa; AMADO, Veronica MoreiraPerspectives on invasive and noninvasive ventilatory support for critically ill patients are evolving, as much evidence indicates that ventilation may have positive effects on patient survival and the quality of the care provided in intensive care units in Brazil. For those reasons, the Brazilian Association of Intensive Care Medicine (Associacao de Medicina Intensiva Brasileira - AMIB) and the Brazilian Thoracic Society (Sociedade Brasileira de Pneumologia e Tisiologia - SBPT), represented by the Mechanical Ventilation Committee and the Commission of Intensive Therapy, respectively, decided to review the literature and draft recommendations for mechanical ventilation with the goal of creating a document for bedside guidance as to the best practices on mechanical ventilation available to their members. The document was based on the available evidence regarding 29 subtopics selected as the most relevant for the subject of interest. The project was developed in several stages, during which the selected topics were distributed among experts recommended by both societies with recent publications on the subject of interest and/or significant teaching and research activity in the field of mechanical ventilation in Brazil. The experts were divided into pairs that were charged with performing a thorough review of the international literature on each topic. All the experts met at the Forum on Mechanical Ventilation, which was held at the headquarters of AMIB in Sao Paulo on August 3 and 4, 2013, to collaboratively draft the final text corresponding to each sub-topic, which was presented to, appraised, discussed and approved in a plenary session that included all 58 participants and aimed to create the final document.
- Brazilian guidelines for the pharmacological treatment of the pulmonary symptoms of cystic fibrosis. Official document of the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association)(2023) ATHANAZIO, Rodrigo Abensur; TANNI, Suzana Erico; FERREIRA, Juliana; DALCIN, Paulo de Tarso Roth; FUCCIO, Marcelo B. de; ESPOSITO, Concetta; CANAN, Mariane Goncalves Martynychen; COELHO, Liana Sousa; FIRMIDA, Monica de Cassia; ALMEIDA, Marina Buarque de; MAROSTICA, Paulo Jose Cauduro; MONTE, Luciana de Freitas Velloso; SOUZA, Edna Lucia; PINTO, Leonardo Araujo; RACHED, Samia Zahi; OLIVEIRA, Veronica Stasiak Bednarczuk de; RIEDI, Carlos Antonio; SILVA FILHO, Luiz Vicente Ribeiro Ferreira daCystic fibrosis (CF) is a genetic disease that results in dysfunction of the CF transmembrane conductance regulator (CFTR) protein, which is a chloride and bicarbonate channel expressed in the apical portion of epithelial cells of various organs. Dysfunction of that protein results in diverse clinical manifestations, primarily involving the respiratory and gastrointestinal systems, impairing quality of life and reducing life expectancy. Although CF is still an incurable pathology, the therapeutic and prognostic perspectives are now totally different and much more favorable. The purpose of these guidelines is to define evidence- based recommendations regarding the use of pharmacological agents in the treatment of the pulmonary symptoms of CF in Brazil. Questions in the Patients of interest, Intervention to be studied, Comparison of interventions, and Outcome of interest (PICO) format were employed to address aspects related to the use of modulators of this protein (ivacaftor, lumacaftor+ivacaftor, and tezacaftor+ivacaftor), use of dornase alfa, eradication therapy and chronic suppression of Pseudomonas aeruginosa, and eradication of methicillin-resistant Staphylococcus aureus and Burkholderia cepacia complex. To formulate the PICO questions, a group of Brazilian specialists was assembled and a systematic review was carried out on the themes, with meta-analysis when applicable. The results obtained were analyzed in terms of the strength of the evidence compiled, the recommendations being devised by employing the GRADE approach. We believe that these guidelines represent a major advance to be incorporated into the approach to patients with CF, mainly aiming to favor the management of the disease, and could become an auxiliary tool in the definition of public policies related to CF.
- Predictors of asynchronies during assisted ventilation and its impact on clinical outcomes: The EPISYNC cohort study(2020) SOUSA, Mayson Laercio de Araujo; MAGRANS, Rudys; HAYASHI, Fatima K.; BLANCH, Lluis; KACMAREK, Robert M.; FERREIRA, Juliana C.Purpose: To investigate if respiratory mechanics and other baseline characteristics are predictors of patient-ventilator asynchrony and to evaluate the relationship between asynchrony during assisted ventilation and clinical outcomes. Methods: We performed a prospective cohort study in patients under mechanical ventilation (MV). Baseline measurements included severity of illness and respiratory mechanics. The primary outcome was the Asynchrony Index (AI), defined as the number of asynchronous events divided by the number of ventilator cycles and wasted efforts. We recorded ventilator waveforms throughout the entire period of MV. Results: We analyzed 11,881 h of MV from 103 subjects. Median AI during the entire period of MV was 5.1% (IQR:2.6-8.7). Intrinsic PEEP was associated with AI (OR:1.72, 95%CI:1.1-2.68), but static compliance and airway resistance were not. Simplified Acute Physiology Score 3 (OR:1.03, 95%CI:1-1.06) was also associated with AI. Median AI was higher during assisted (5.4%, IQR:2.9-9.1) than controlled (2%, IQR:0.6-4.9) ventilation, and 22% of subjects had high incidence of asynchrony (AI=10%). Subjects with AI=10% had more extubation failure (33%) than patients with AIb10% (6%), p =.01. Conclusions: Predictors of high incidence of asynchrony were severity of illness and intrinsic PEEP. High incidence of asynchrony was associated with extubation failure, but not mortality. Trial registration: ClinicalTrials.gov, NCT02687802 (c) 2020 Elsevier Inc. All rights reserved.
- Impact on the ability of healthcare professionals to correctly identify patient-ventilator asynchronies of the simultaneous visualization of estimated muscle pressure curves on the ventilator display: a randomized study (P-mus study)(2023) SILVA, Daniel Oliveira; SOUZA, Patricia Nery de; SOUSA, Mayson Laercio de Araujo; MORAIS, Caio Cesar Araujo; FERREIRA, Juliana Carvalho; HOLANDA, Marcelo Alcantara; YAMAGUTI, Wellington Pereira; PASTORE JUNIOR, Laerte; COSTA, Eduardo Leite VieiraBackgroundPatient-ventilator asynchronies are usually detected by visual inspection of ventilator waveforms but with low sensitivity, even when performed by experts in the field. Recently, estimation of the inspiratory muscle pressure (P-mus) waveforms through artificial intelligence algorithm has been proposed (Magnamed (R), Sao Paulo, Brazil). We hypothesized that the display of these waveforms could help healthcare providers identify patient-ventilator asynchronies.MethodsA prospective single-center randomized study with parallel assignment was conducted to assess whether the display of the estimated P-mus waveform would improve the correct identification of asynchronies in simulated clinical scenarios. The primary outcome was the mean asynchrony detection rate (sensitivity). Physicians and respiratory therapists who work in intensive care units were randomized to control or intervention group. In both groups, participants analyzed pressure and flow waveforms of 49 different scenarios elaborated using the ASL-5000 lung simulator. In the intervention group the estimated P-mus waveform was displayed in addition to pressure and flow waveforms.ResultsA total of 98 participants were included, 49 per group. The sensitivity per participant in identifying asynchronies was significantly higher in the P-mus group (65.8 +/- 16.2 vs. 52.94 +/- 8.42, p < 0.001). This effect remained when stratifying asynchronies by type.ConclusionsWe showed that the display of the P-mus waveform improved the ability of healthcare professionals to recognize patient-ventilator asynchronies by visual inspection of ventilator tracings. These findings require clinical validation.Trial registration: ClinicalTrials.gov: NTC05144607. Retrospectively registered 3 December 2021.
- Enhancing Recruitment and Retention of Minority Populations for Clinical Research in Pulmonary, Critical Care, and Sleep Medicine An Official American Thoracic Society Research Statement(2021) THAKUR, Neeta; LOVINSKY-DESIR, Stephanie; APPELL, Donna; BIME, Christian; CASTRO, Lauren; CELEDON, Juan C.; FERREIRA, Juliana; GEORGE, Maureen; MAGETO, Yolanda; III, Arch G. Mainous; PAKHALE, Smita; RIEKERT, Kristin A.; ROMAN, Jesse; RUVALCABA, Elizabeth; SHARMA, Sunil; SHETE, Priya; WISNIVESKY, Juan P.; HOLGUIN, FernandoBackground: Well-designed clinical research needs to obtain information that is applicable to the general population. However, most current studies fail to include substantial cohorts of racial/ethnic minority populations. Such underrepresentation may lead to delayed diagnosis or misdiagnosis of disease, wide application of approved interventions without appropriate knowledge of their usefulness in certain populations, and development of recommendations that are not broadly applicable. Goals: To develop best practices for recruitment and retention of racial/ethnic minorities for clinical research in pulmonary, critical care, and sleep medicine. Methods: The American Thoracic Society convened a workshop in May of 2019. This included an international interprofessional group from academia, industry, the NIH, and the U.S. Food and Drug Administration, with expertise ranging from clinical and biomedical research to community-based participatory research methods and patient advocacy. Workshop participants addressed historical and current mistrust of scientific research, systemic bias, and social and structural barriers to minority participation in clinical research. A literature search of PubMed and Google Scholar was performed to support conclusions. The search was not a systematic review of the literature. Results: Barriers at the individual, interpersonal, institutional, and federal/policy levels were identified as limiting to minority participation in clinical research. Through the use of a multilevel framework, workshop participants proposed evidence-based solutions to the identified barriers. Conclusions: To date, minority participation in clinical research is not representative of the U.S. and global populations. This American Thoracic Society research statement identifies potential evidence-based solutions by applying a multilevel framework that is anchored in community engagement methods and patient advocacy.
- Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic(2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, GeraldoIntroduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
- Prediction of intensive care admission and hospital mortality in COVID-19 patients using demographics and baseline laboratory data(2023) AVELINO-SILVA, Vivian I.; AVELINO-SILVA, Thiago J.; ALIBERTI, Marlon J. R.; FERREIRA, Juliana C.; COBELLO JUNIOR, Vilson; SILVA, Katia R.; POMPEU, Jose E.; ANTONANGELO, Leila; MAGRI, Marcello M.; BARROS FILHO, Tarcisio E. P.; SOUZA, Heraldo P.; KALLAS, Esper G.Introduction: Optimized allocation of medical resources to patients with COVID-19 has been a critical concern since the onset of the pandemic.Methods: In this retrospective cohort study, the authors used data from a Brazilian tertiary university hospital to explore predictors of Intensive Care Unit (ICU) admission and hospital mortality in patients admitted for COVID19. Our primary aim was to create and validate prediction scores for use in hospitals and emergency departments to aid clinical decisions and resource allocation. Results: The study cohort included 3,022 participants, of whom 2,485 were admitted to the ICU; 1968 survived, and 1054 died in the hospital. From the complete cohort, 1,496 patients were randomly assigned to the derivation sample and 1,526 to the validation sample. The final scores included age, comorbidities, and baseline laboratory data. The areas under the receiver operating characteristic curves were very similar for the derivation and validation samples. Scores for ICU admission had a 75% accuracy in the validation sample, whereas scores for death had a 77% accuracy in the validation sample. The authors found that including baseline flu-like symptoms in the scores added no significant benefit to their accuracy. Furthermore, our scores were more accurate than the previously published NEWS-2 and 4C Mortality Scores.Discussion and conclusions: The authors developed and validated prognostic scores that use readily available clinical and laboratory information to predict ICU admission and mortality in COVID-19. These scores can become valuable tools to support clinical decisions and improve the allocation of limited health resources.