Caracterização Demográfica, Curso Clínico e Fatores de Risco para Mortalidade em Doentes Hospitalizados com COVID-19: Experiência de um Hospital Terciário Português na Primeira Vaga da Pandemia
DOI:
https://doi.org/10.24950/O/30/21/2/2021Palavras-chave:
COVID-19, Demografia, Factores de Risco, Mortalidade, Portugal, SARS-CoV-2Resumo
Introdução: As informações relativas às características clínicas e demográficas dos doentes portugueses hospitalizados com COVID-19 são limitadas.
Material e Métodos: Estudo ambispetivo dos doentes internados com COVID-19 num hospital terciário português entre março e agosto de 2020. Foram excluídos os doentes assintomáticos, mulheres grávidas e os internados por causas sociais.
Resultados: Dos 432 doentes internados, foram incluídos 279. A idade mediana foi de 69 anos, 57% do sexo masculino. As comorbilidades mais frequentes foram a hipertensão arterial (66,3%), dislipidémia (33,3%), diabetes (27,1%) e doença cardiovascular (DCV) (26,5%). A sintomatologia mais frequente à admissão foi febre (74,4%), tosse (67,0%) e dispneia (59,9%). As alterações laboratoriais mais frequentes foram níveis elevados de ferritina (86,3%), proteína c-reativa (74,8%) e d-dímeros (73,9%). A taxa de mortalidade foi 17,3%, 32,3% dos doentes desenvolveram síndrome de dificuldade respiratória aguda, 31,9% foram admitidos numa unidade de cuidados intensivos e 20,8% foram ventilados mecanicamente. Na análise multivariável, a idade (OR 1,04, 95% CI 1,01–1,09, p=0,023), DCV (OR 2,68, 95% CI 1,21–5,93, p=0,015) e linfopenia <0,5x109/L (OR 6,61, 95% CI 2,23–19,62, p=0,001) identificaram-se como os principais fatores de risco de mortalidade intra-hospitalar.
Discussão: Os nossos dados demográficos e desfechos clínicos equiparam-se aos estudos publicados até à data. Em comparação com os estudos em populações europeias, relatamos uma menor taxa de mortalidade intra-hospitalar, o que poderá refletir um melhor controlo da primeira vaga da pandemia no nosso país.
Conclusão: Este estudo fornece informação acerca das características clínicas dos doentes com COVID-19 hospitalizados em Portugal.
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