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Observational Study
. 2021 Jan 7;16(1):e0244532.
doi: 10.1371/journal.pone.0244532. eCollection 2021.

Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study

Rodrigo A Brandão Neto  1 , Julio F Marchini  1 , Lucas O Marino  1 , Julio C G Alencar  1 , Felippe Lazar Neto  1 , Sabrina Ribeiro  1 , Fernando V Salvetti  1 , Hassan Rahhal  1 , Luz Marina Gomez Gomez  1 , Caue G Bueno  1 , Carine C Faria  1 , Victor P da Cunha  1 , Eduardo Padrão  1 , Irineu T Velasco  1 , Heraldo Possolo de Souza  2 ; Emergencia USP Covid group
Affiliations
Observational Study

Mortality and other outcomes of patients with coronavirus disease pneumonia admitted to the emergency department: A prospective observational Brazilian study

Rodrigo A Brandão Neto et al. PLoS One. .

Erratum in

Abstract

Background: The first cases of coronavirus disease (COVID-19) in Brazil were diagnosed in February 2020. Our Emergency Department (ED) was designated as a COVID-19 exclusive service. We report our first 500 confirmed COVID-19 pneumonia patients.

Methods: From 14 March to 16 May 2020, we enrolled all patients admitted to our ED that had a diagnosis of COVID-19 pneumonia. Infection was confirmed via nasopharyngeal swabs or tracheal aspirate PCR. The outcomes included hospital discharge, invasive mechanical ventilation, and in-hospital death, among others.

Results: From 2219 patients received in the ED, we included 506 with confirmed COVID-19 pneumonia. We found that 333 patients were discharged home (65.9%), 153 died (30.2%), and 20 (3.9%) remained in the hospital. A total of 300 patients (59.3%) required ICU admission, and 227 (44.9%) needed invasive ventilation. The multivariate analysis found age, number of comorbidities, extension of ground glass opacities on chest CT and troponin with a direct relationship with all-cause mortality, whereas dysgeusia, use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker and number of lymphocytes with an inverse relationship with all-cause mortality.

Conclusions: This was a sample of severe patients with COVID-19, with 59.2% admitted to the ICU and 41.5% requiring mechanical ventilator support. We were able to ascertain the outcome in majority (96%) of patients. While the overall mortality was 30.2%, mortality for intubated patients was 55.9%. Multivariate analysis agreed with data found in other studies although the use of angiotensin converting enzyme inhibitor or angiotensin-ii receptor blocker as a protective factor could be promising but would need further studies.

Trial registration: The study was registered in the Brazilian registry of clinical trials: RBR-5d4dj5.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study design and participants.
COVID-19, coronavirus disease; RT-PCR, reverse transcription–polymerase chain reaction.
Fig 2
Fig 2. Timeline of coronavirus disease (COVID-19) cases after onset of illness.
*: ICU intensive care unit.
See this image and copyright information in PMC

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