Epidemiology, outcomes, and the use of intensive care unit resources of critically ill patients diagnosed with COVID-19 in Sao Paulo, Brazil: A cohort study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSOCOLOVITHC, Rachel Lane
dc.contributor.authorFUMIS, Renata Rego Lins
dc.contributor.authorTOMAZINI, Bruno Martins
dc.contributor.authorPASTORE, Laerte
dc.contributor.authorGALAS, Filomena Regina Barbosa Gomes
dc.contributor.authorAZEVEDO, Luciano Cesar Pontes de
dc.contributor.authorCOSTA, Eduardo Leite Vieira
dc.date.accessioned2021-02-18T13:25:22Z
dc.date.available2021-02-18T13:25:22Z
dc.date.issued2020
dc.description.abstractBackground The coronavirus disease (COVID-19) pandemic has brought significant challenges worldwide, with high mortality, increased use of hospital resources, and the collapse of healthcare systems. We aimed to describe the clinical outcomes of critically ill COVID-19 patients and assess the impact on the use of hospital resources and compare with critically ill medical patients without COVID-19. Methods and findings In this retrospective cohort study, we included patients diagnosed with COVID-19 admitted to a private ICU in Sao Paulo, Brazil from March to June 2020. We compared these patients with those admitted to the unit in the same period of the previous year. A total of 212 consecutive patients with a confirmed diagnosis of COVID-19 were compared with 185 medical patients from the previous year. Patients with COVID-19 were more frequently males (76% vs. 56%, p<0.001) and morbidly obese (7.5% vs. 2.2%, p = 0.027), and had lower SAPS 3 (49.65 (12.19) vs. 55.63 (11.94), p<0.001) and SOFA scores (3.78 (3.53) vs. 4.48 (3.11), p = 0.039). COVID-19 patients had a longer ICU stay (median of 7 vs. 3 days, p<0.001), longer duration of mechanical ventilation (median of 9 vs. 4 days, p = 0.003), and more frequent tracheostomies (10.8 vs. 1.1%, p<0.001). Survival rates until 28 days were not statistically different (91% vs. 85.4%, p = 0.111). After multivariable adjustment for age, gender, SAPS 3, and Charlson Comorbidity Index, COVID-19 remained not associated with survival at 28 days (HR 0.59, 95% CI 0.33-1.06, p = 0.076). Among patients who underwent invasive mechanical ventilation, the observed mortality at 28-days was 16.2% in COVID-19 patients compared to 34.6% in the previous year. Conclusions COVID-19 required more hospital resources, including invasive and non-invasive ventilation, had a longer duration of mechanical ventilation, and a more prolonged ICU and hospital length of stay. There was no difference in all-cause mortality at 28 and 60 days, suggesting that health systems preparedness be an important determinant of clinical outcomes.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipSirio-Libanes Hospital
dc.identifier.citationPLOS ONE, v.15, n.12, article ID e0243269, 13p, 2020
dc.identifier.doi10.1371/journal.pone.0243269
dc.identifier.issn1932-6203
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/39015
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCEeng
dc.relation.ispartofPlos One
dc.rightsopenAccesseng
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCEeng
dc.subject.wosMultidisciplinary Scienceseng
dc.titleEpidemiology, outcomes, and the use of intensive care unit resources of critically ill patients diagnosed with COVID-19 in Sao Paulo, Brazil: A cohort studyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalSOCOLOVITHC, Rachel Lane:Hosp Sirio Libanes, Adult Intens Care Unit, Sao Paulo, Brazil
hcfmusp.author.externalFUMIS, Renata Rego Lins:Hosp Sirio Libanes, Adult Intens Care Unit, Sao Paulo, Brazil; Hosp Sirio Libanes, Res & Educ Inst, Sao Paulo, Brazil
hcfmusp.author.externalTOMAZINI, Bruno Martins:Hosp Sirio Libanes, Adult Intens Care Unit, Sao Paulo, Brazil; Hosp Sirio Libanes, Res & Educ Inst, Sao Paulo, Brazil
hcfmusp.author.externalPASTORE, Laerte:Hosp Sirio Libanes, Adult Intens Care Unit, Sao Paulo, Brazil
hcfmusp.citation.scopus13
hcfmusp.contributor.author-fmusphcFILOMENA REGINA BARBOSA GOMES GALAS
hcfmusp.contributor.author-fmusphcLUCIANO CESAR PONTES DE AZEVEDO
hcfmusp.contributor.author-fmusphcEDUARDO LEITE VIEIRA COSTA
hcfmusp.description.articlenumbere0243269
hcfmusp.description.issue12
hcfmusp.description.volume15
hcfmusp.origemWOS
hcfmusp.origem.pubmed33270741
hcfmusp.origem.scopus2-s2.0-85097125009
hcfmusp.origem.wosWOS:000597149100009
hcfmusp.publisher.citySAN FRANCISCOeng
hcfmusp.publisher.countryUSAeng
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Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - COVID-19
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