Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study

巴西圣保罗市一家大型三级医院收治的一组 COVID-19 患者的死亡率预测因素:一项回顾性研究

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作者:Regina Maria Alexandre Fernandes de Oliveira, Milton Luiz Gorzoni, Ronaldo Fernandes Rosa

Background

There is discrepant information across countries regarding the natural history of patients admitted to hospitals with coronavirus disease (COVID-19), in addition to a lack of data on the scenario in Brazil.

Conclusion

The main predictors of in-hospital mortality after logistic regression analysis were age, O2 saturation ≤ 94% upon admission, use of vasoactive drugs, and presence of thrombocytopenia.

Methods

Overall, 316 patients with laboratory-confirmed COVID-19 between March 1, 2020, and July 31, 2020, were included. The analysis included the baseline characteristics, clinical progression, and outcomes.

Objective

To determine the mortality predictors in COVID-19 patients admitted to a tertiary hospital in São Paulo, Brazil. Design and setting: A retrospective analysis of medical records of COVID-19 patients admitted to the Hospital Central da Irmandade da Santa Casa de Misericórdia of São Paulo.

Results

The mortality rate of the sample was 51.27%. Age ≥ 60 years was determined as a risk factor after multivariate logistic regression analysis. Patients with an oxygen (O2) saturation ≤ 94% upon admission accounted for 87% of the deaths (P < 0.001). Vasoactive drugs were used in 92% (P < 0.001) of patients who progressed to death, and mechanical ventilation was employed in 88% (P < 0.001) of such patients. However, patients who received corticosteroids concomitantly with mechanical ventilation had a better prognosis than those who did not. The progressive degree of pulmonary involvement observed on chest computed tomography was correlated with a worse prognosis. The presence of thrombocytopenia has been considered as a risk factor for mortality.

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