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Observational Study
. 2024 Aug 9:22:eAO0652.
doi: 10.31744/einstein_journal/2024AO0652. eCollection 2024.

Mortality, hospitalizations, and persistence of symptoms in the outpatient setting of the first COVID-19 wave in Brazil: results of SARS-Brazil cohort study

Henrique Andrade Rodrigues Fonseca  1 , Adriano Jose Pereira  1 , Ricardo Kenji Nawa  1 , Viviane Aparecida Rodrigues Sant'Anna  1 , Tatiana Ferreira de Almeida  1 , Hélio Penna Guimarães  1 , Alexandre Pereira Tognon  2 , Lucas Miranda Marques  3 , Lucas Santana Coelho da Silva  3 , Rafaela de Souza Bittencourt  3 , Camila Pachêco Gomes  4 , Priscila de Aquino Martins  5 , Aryadne Lyrio de Oliveira  5 , Eveline Pipolo Milan  6 , Frederico Toledo Campos Dall'Orto  7 , Conrado Roberto Hoffman Filho  8 , Guacyra Almeida  9 , Fábio Barlem Hohmann  1 , Diogo Duarte Fagundes Moia  1 , Luciana Pereira Almeida Piano  1 , Felipe Pinheiro Machado  1 , Ronaldo Vicente Pereira Soares  1 , Lucas Petri Damiani  1 , Silvia Regina Lamas Assis  1 , Edson Amaro Junior  1 , Luiz Vicente Rizzo  1 , Otávio Berwanger  1
Affiliations
Observational Study

Mortality, hospitalizations, and persistence of symptoms in the outpatient setting of the first COVID-19 wave in Brazil: results of SARS-Brazil cohort study

Henrique Andrade Rodrigues Fonseca et al. Einstein (Sao Paulo). .

Abstract

Objective: To evaluate deaths, hospitalizations, and persistence of symptoms in patients with COVID-19 after infection in an outpatient setting during the first COVID-19 wave in Brazil.

Methods: This prospective cohort was between April 2020 and February 2021. Hospitalized or non-hospitalized COVID-19 patients until five days after symptom onset were included. The outcomes measured were incidence of death, hospitalization, and persistence of more than two symptoms 60 days after discharge.

Results: Out of 1,198 patients enrolled in the study, 66.7% were hospitalized. A total of 289 patients died (1 [0.3%] non-hospitalized and 288 [36%] hospitalized). At 60 days, patients non-hospitalized during admission had more persistent symptoms (16.2%) compared to hospitalized (37.1%). The COVID-19 severity variables associated with the persistence of two or more symptoms were increased age (OR= 1.03; p=0.015), respiratory rate at hospital admission (OR= 1.11; p=0.005), length of hospital stay of more than 60 days (OR= 12.24; p=0.026), and need for intensive care unit admission (OR= 2.04; p=0.038).

Conclusion: COVID-19 survivors who were older, tachypneic at admission, had a hospital length of stay >60 days, and were admitted to the intensive care unit had more persistent symptoms than patients who did not require hospitalization in the early COVID-19 waves.ClinicalTrials.gov Identifier: NCT04479488.

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Conflict of interest statement

Conflict of interest: none.

Figures

None
Graphical abstract
Figure 1
Figure 1. Flowchart of inclusion and exclusion of participants in the current analysis
Figure 2
Figure 2. A) Logistic regression to estimate the risk of hospitalization due to COVID-19; B) Logistic regression to estimate the risk of death after hospitalization due to COVID-19; C) Logistic regression to estimate the risk of ≥2 symptoms persistence at 60 days in outpatient setting
Bpm: breath per minute; 95%CI: 95% confidential interval; OR: odds ratio.
Figure 3
Figure 3. Symptoms reported among COVID-19 outpatients after 60 days
NYHA dyspnea, New York Heart Association dyspnea scale: Dark Gray bars represent the non-hospitalized group, and gray bars represent the hospitalized group.
See this image and copyright information in PMC

References

    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. - PMC - PubMed
    1. Petersen E, Koopmans M, Go U, Hamer DH, Petrosillo N, Castelli F, et al. Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics. Lancet Infect Dis. 2020;20(9):e238–e244. - PMC - PubMed
    1. Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med. 2022;10(9):863–876. - PMC - PubMed
    1. Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601–615. - PMC - PubMed
    1. Robineau O, Wiernik E, Lemogne C, de Lamballerie X, Ninove L, Blanché H, et al. Persistent symptoms after the first wave of COVID-19 in relation to SARS-CoV-2 serology and experience of acute symptoms: a nested survey in a population-based cohort. 100363Lancet Reg Health Eur. 2022;17 - PMC - PubMed

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