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. 2021 Jun:107:300-310.
doi: 10.1016/j.ijid.2021.01.019. Epub 2021 Jan 12.

Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry

Milena S Marcolino  1 , Patricia K Ziegelmann  2 , Maira V R Souza-Silva  3 , I J B Nascimento  4 , Luana M Oliveira  5 , Luanna S Monteiro  6 , Thaís L S Sales  7 , Karen B Ruschel  8 , Karina P M P Martins  9 , Ana Paula B S Etges  10 , Israel Molina  11 , Carisi A Polanczyk  12 ; Brazilian COVID-19 Registry Investigators
Collaborators, Affiliations

Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry

Milena S Marcolino et al. Int J Infect Dis. 2021 Jun.

Abstract

Objectives: To describe the clinical characteristics, laboratory results, imaging findings, and in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals.

Methods: A cohort study of laboratory-confirmed COVID-19 patients who were hospitalized from March 2020 to September 2020 in 25 hospitals. Data were collected from medical records using Research Electronic Data Capture (REDCap) tools. A multivariate Poisson regression model was used to assess the risk factors for in-hospital mortality.

Results: For a total of 2,054 patients (52.6% male; median age of 58 years), the in-hospital mortality was 22.0%; this rose to 47.6% for those treated in the intensive care unit (ICU). Hypertension (52.9%), diabetes (29.2%), and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation, and 12.1% required kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1%, and acute heart failure in 3.6%. Age >= 65 years, chronic kidney disease, hypertension, C-reactive protein ≥ 100mg/dL, platelet count < 100×109/L, oxygen saturation < 90%, the need for supplemental oxygen, and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%.

Conclusions: This study reveals the characteristics and in-hospital outcomes of hospitalized patients with confirmed COVID-19 in Brazil. Certain easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.

Keywords: Brazil; COVID-19; SARS-CoV-2; disease progression; hospitalizations; mortality; pandemic.

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Figures

Figure 1
Figure 1
Flowchart of COVID-19 patients included in the study.
Figure 2
Figure 2
Seven-day moving average of (A) COVID-19 inpatient hospital admissions; (B) number of patients hospitalized for COVID-19; (C) number of COVID-19 deaths; (D) mortality among hospitalized COVID-19 patients (number of deaths/number of patients hospitalized).
See this image and copyright information in PMC

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