Abstract
Objective: to analyze the epidemiological aspects and factors associated with the survival of critically ill patients diagnosed with Covid-19. Method: this is a non-concurrent cohort study with information from 205 critically ill Covid-19 patients. Results: the incidence and lethality of Covid-19 were, respectively, 60.3% and 46.8%. The mean survival time of patients was 21.8 days, and the factors associated with lower survival were high score on the Simplified Acute Physiology Score, shorter time on mechanical ventilation, altered level of consciousness, use of a central venous catheter, presence of coagulopathies and need for cardiopulmonary resuscitation. Patients on oxygen therapy by nasal cannula had better survival. Conclusion: there was a high incidence and lethality of the disease among critically ill patients. The lowest survival rate was related to indicators of greater severity of the clinical picture. The results support nurses in planning patient care to minimize the risk of death.
References
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):1054-62. http://dx.doi.org/10.1016/S0140-6736(20)30566-3. PMid:32171076.
World Health Organization. Coronavirus (COVID-19) outbreak [Internet]. 2020 [cited 2020 May 31]. Available from: https://www.who.int/westernpacific/emergencies/covid-19
Ministério da Saúde (BR), Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde (SCTIE). Diretrizes para diagnóstico e tratamento da Covid-19. [Internet]. Brasília, DF: Ministério da Saúde; 2020. [cited 2020 Apr 27]. Available from: https://pncq.org.br/uploads/2020-1/Diretriz-Covid19-v4-07-05.20h05m.pdf
World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. 2021 [cited 2021 July 9]. Available from: https://covid19.who.int/
Ministério da Saúde (BR). Painel Coronavírus [Internet]. Brasília, DF: Ministério da Saúde; 2021 [cited 2021 July 10]. Available from: https://covid.saude.gov.br/
Ranzani OT, Bastos LS, Gelli JG, Marchesi JF, Baião F, Hamacher S, et al. Characterisation of the first 250.000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data. Lancet Respir Med. 2021;9(4):407-18. PMid:33460571.
Castro MC, Gurzenda S, Macário EM, França GV. Characteristics, outcomes and risk factors for mortality of 522 167 patients hospitalised with COVID-19 in Brazil: a retrospective cohort study. BMJ Open. 2021;11(5):e049089. http://dx.doi.org/10.1136/bmjopen-2021-049089. PMid:33947740.
Holanda MA, Pinheiro BV. COVID-19 pandemic and mechanical ventilation: facing the present, designing the future. J Bras Pneumol. 2020;46(4):e20200282. http://dx.doi.org/10.36416/1806-3756/e20200282. PMid:32696835.
Miot HA. Survival analysis in clinical and experimental studies. J Vasc Bras. 2017;16(4):267-9. http://dx.doi.org/10.1590/1677-5449.001604. PMid:29930659.
Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345-55. http://dx.doi.org/10.1001/jamainternmed.2020.3539. PMid:32667669.
Choron RL, Butts CA, Bargoud C, Krumrei NJ, Teichman AL, Schroeder ME, et al. Fever in the ICU: a predictor of mortality in mechanically ventilated COVID-19 patients. J Intensive Care Med. 2021;36(4):484-93. http://dx.doi.org/10.1177/0885066620979622. PMid:33317374.
Timenetsky KT, Serpa A No, Lazarin AC, Pardini A, Moreira CR, Corrêa TD, et al. The Perme Mobility Index: a new concept to assess mobility level in patients with coronavirus (COVID-19) infection. PLoS One. 2021;16(4):e0250180. http://dx.doi.org/10.1371/journal.pone.0250180. PMid:33882081.
Ferreira JC, Ho YL, Besen BAMP, Malbouisson LMS, Taniguchi LU, Mendes PV, et al. Protective ventilation and outcomes of critically ill patients with COVID-19: a cohort study. Ann Intensive Care. 2021;11(1):92. PMid:34097145.
Donato M, Carini FC, Meschini MJ, Saubidet IL, Goldberg A, Sarubio MG, et al. Consensus for the management of analgesia, sedation and delirium in adults with COVID-19-associated acute respiratory distress syndrome. Rev Bras Ter Intensiva. 2021;33(1):48-67. PMid:33886853.
Payen JF, Chanques G, Futier E, Velly L, Jaber S, Constantin JM. Sedation for critically ill patients with COVID-19: which specificities? One size does not fit all. Anaesth Crit Care Pain Med. 2020;39(3):341-3. http://dx.doi.org/10.1016/j.accpm.2020.04.010. PMid:32360979.
Michard F, Malbrain ML, Martin GS, Fumeaux T, Lobo S, Gonzalez F, et al. Haemodynamic monitoring and management in COVID-19 intensive care patients: an International survey. Anaesth Crit Care Pain Med. 2020;39(5):563-9. http://dx.doi.org/10.1016/j.accpm.2020.08.001. PMid:32781167.
Selby LM, Rupp ME, Cawcutt KA. Prevention of central-line associated bloodstream infections: 2021 Update. Infect Dis Clin North Am. 2021;35(4):841-56. http://dx.doi.org/10.1016/j.idc.2021.07.004. PMid:34752222.
Polimeni A, Leo I, Spaccarotella C, Mongiardo A, Sorrentino S, Sabatino I, et al. Differences in coagulopathy indices in patients with severe versus non-severe COVID-19: a meta-analysis of 35 studies and 6427 patients. Sci Rep. 2021;11(1):10464. http://dx.doi.org/10.1038/s41598-021-89967-x. PMid:34001992.
Nascimento JH, Costa RL, Simvoulidis LF, Pinho JC, Pereira RS, Porto AD, et al. COVID-19 e injúria miocárdica em UTI brasileira: alta incidência e maior risco de mortalidade intra-hospitalar. Arq Bras Cardiol. 2021;116(2):275-82. http://dx.doi.org/10.36660/abc.20200671. PMid:33470333.
Metnitz PG, Moreno RP, Fellinger T, Posch M, Zajic P. Evaluation and calibration of SAPS 3 in patients with COVID-19 admitted to intensive care units. Intensive Care Med. 2021;47(8):910-2. http://dx.doi.org/10.1007/s00134-021-06436-9. PMid:34009450.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Array