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Fatores associados à mortalidade por Covid-19 - um estudo transversal no Hospital Nacional Simão Mendes
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No final de dezembro de 2019, em Wuhan, na província chinesa de Hubei,
surgiram relatos de alguns pacientes que apresentavam uma doença respiratória
aguda, semelhante a sintomas gripais, mas com evolução, aparentemente, mais
grave. No início de janeiro de 2020, foi identificado o vírus responsável pela
doença, um coronavírus, que foi denominado SARS-CoV-2, por analogia com a
SARS (Severe Acute Respiratory Syndrome) e a doença, COVID-19. A rápida
evolução e disseminação da infeção levou a ser considerada pela OMS como uma
emergência global, sendo declarada como pandemia a 11 de março de 2020. No
dia 25 de março de 2020, três meses depois de surgir na China, foram anunciados
os primeiros dois casos de COVID-19 na Guiné-Bissau. Este estudo teve como
objetivo caracterizar os fatores associados a mortalidade por COVID19, na Guiné
Bissau, através de um estudo transversal, com os dados clínicos dos pacientes
internados no centro de tratamento dedicado. A regressão logística bivariada e
multivariada foi utilizada para identificação dos fatores associados aodiagnóstico
tardio, pelo cálculo do Odds Ratio Bruto (OR). A amostra foi uma amostra de
conveniência, tendo-se selecionado todos os doentes internados no período de
estudo. Os fatores associados a maior risco de morte foram idade (OR=2,204; IC
95%: 1,155 - 4,205), d-dímero (OR= 8,233 IC 95% 2,355 - 28,782), fadiga (OR=
2,374 IC 95%: 1,035 - 5,444), associados a maior risco de morte por COVID-19
na Guiné-Bissau. Este estudo também identificou fatores de proteção que são
enoxiparina (OR=0.201; IC 95%: 0.042 – 0.968), dexametasona (OR=0.067 IC
95% (0.008 – 0.580). Torna-se necessário implementar medidas que permitam
atenuar o efeito desses fatores e, dessa forma, contribuir para redução da
mortalidade por COVID-19.
At the end of December 2019, in Wuhan, in the Chinese province of Hubei, there were reports of some patients who had an acute respiratory illness, similar to flu-like symptoms, but with an apparently more serious evolution. In early January 2020, the virus responsible for the disease was identified, a coronavirus, which was named SARS-CoV-2, by analogy with SARS (Severe Acute Respiratory Syndrome) and the disease, COVID-19. The rapid evolution and spread of the infection led to it being considered by the WHO as a global emergency, being declared a pandemic on March 11, 2020. On March 25, 2020, three months after it appeared in China, the first two cases of COVID-19 in Guinea-Bissau. This study aimed to characterize the factors associated with mortality from COVID19, in Guinea Bissau, through a cross-sectional study, with the clinical data of patients admitted to the dedicated treatment center. Bivariate and multivariate logistic regression was used to identify factors associated with late diagnosis, by calculating the Gross Odds Ratio (OR). The sample was a convenience sample, having selected all patients hospitalized during the study period. The factors associated with a higher risk of death were age (OR=2.204; 95% CI: 1.155 - 4.205), d-dimer (OR= 8.233 95% CI 2.355 - 28.782), fatigue (OR= 2.374 95% CI: 1.035 - 5,444), associated with a higher risk of death from COVID-19 in Guinea-Bissau. This study also identified protective factors that are enoxiparin (OR=0.201; CI 95%: 0.042 – 0.968), dexamethasone (OR=0.067 CI 95% (0.008 – 0.580). It is necessary to implement measures to attenuate the effect of these factors and, in this way, contribute to the reduction of mortality from COVID-19.
At the end of December 2019, in Wuhan, in the Chinese province of Hubei, there were reports of some patients who had an acute respiratory illness, similar to flu-like symptoms, but with an apparently more serious evolution. In early January 2020, the virus responsible for the disease was identified, a coronavirus, which was named SARS-CoV-2, by analogy with SARS (Severe Acute Respiratory Syndrome) and the disease, COVID-19. The rapid evolution and spread of the infection led to it being considered by the WHO as a global emergency, being declared a pandemic on March 11, 2020. On March 25, 2020, three months after it appeared in China, the first two cases of COVID-19 in Guinea-Bissau. This study aimed to characterize the factors associated with mortality from COVID19, in Guinea Bissau, through a cross-sectional study, with the clinical data of patients admitted to the dedicated treatment center. Bivariate and multivariate logistic regression was used to identify factors associated with late diagnosis, by calculating the Gross Odds Ratio (OR). The sample was a convenience sample, having selected all patients hospitalized during the study period. The factors associated with a higher risk of death were age (OR=2.204; 95% CI: 1.155 - 4.205), d-dimer (OR= 8.233 95% CI 2.355 - 28.782), fatigue (OR= 2.374 95% CI: 1.035 - 5,444), associated with a higher risk of death from COVID-19 in Guinea-Bissau. This study also identified protective factors that are enoxiparin (OR=0.201; CI 95%: 0.042 – 0.968), dexamethasone (OR=0.067 CI 95% (0.008 – 0.580). It is necessary to implement measures to attenuate the effect of these factors and, in this way, contribute to the reduction of mortality from COVID-19.
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Palavras-chave
Doenças tropicais Covid-19 Fatores de risco Mortalidade Guiné- Bissau