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. 2021 Mar 18;16(3):e0248580.
doi: 10.1371/journal.pone.0248580. eCollection 2021.

On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database

Fernanda Sumika Hojo de Souza  1 , Natália Satchiko Hojo-Souza  2 , Ben Dêivide de Oliveira Batista  3 , Cristiano Maciel da Silva  4 , Daniel Ludovico Guidoni  1
Affiliations

On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database

Fernanda Sumika Hojo de Souza et al. PLoS One. .

Abstract

Background: Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand.

Methods: This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe) regarding notified cases of hospitalized COVID-19 patients during the period from February 26th to August 10th, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed.

Results: The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the lethality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Cardiac disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with cardiac disease (65.7%) and diabetes (53.55%) and with a high lethality rate of around 50% was observed. The intensive care unit (ICU) admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities.

Conclusion: Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of SIVEP-Gripe data used in the study.
Fig 2
Fig 2. Outcome (A) and mortality density (B) distribution by age disaggregated data and gender of the study population (n = 162,045).
Fig 3
Fig 3. Outcome distribution according to demographic characteristics.
Different number of patients apply (Brazilian regions: n = 162,045, race: n = 110,503, education: n = 54,547).
Fig 4
Fig 4. Most frequent clinical characteristics (A) and comorbidities (B) in the study population.
Fig 5
Fig 5. Mortality prognosis based on the general characteristics of patients in an adjusted Cox regression model (CI 95%) n = 44,128.
Fig 6
Fig 6. Mortality prognosis according to patient ventilation requirement in an adjusted Cox regression model (95% CI).
Fig 7
Fig 7. Mortality prognosis according to patient age range in an adjusted Cox regression model (95% CI).
See this image and copyright information in PMC

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