Prospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2023; 11(8): 1761-1770
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1761
Epidemiological and clinical characteristics of COVID-19 in a Brazilian public hospital
Fillipe Dantas Pinheiro, Luana Weber Lopes, Rafael Santos Dantas Miranda Dórea, Glauber Rocha Lima Araújo, Filipe Antônio França da Silva, Breno Bittencourt de Brito, Maria Luísa Cordeiro Santos, Geovani Moreno Santos Júnior, Maria Teresa Araújo de Lorenzo Barcia, Renata de Amorim Marques, André Bezerra Botelho, Anna Carolina Saúde Dantas, Davi Tanajura Costa, Adriano Fernandes Teixeira, Cláudio Lima Souza, Lucas Miranda Marques, Guilherme Barretos Campos, Márcio Vasconcelos Oliveira, Dulciene Maria de Magalhães Queiroz, Fabrício Freire de Melo
Fillipe Dantas Pinheiro, Luana Weber Lopes, Rafael Santos Dantas Miranda Dórea, Glauber Rocha Lima Araújo, Filipe Antônio França da Silva, Breno Bittencourt de Brito, Maria Luísa Cordeiro Santos, André Bezerra Botelho, Anna Carolina Saúde Dantas, Davi Tanajura Costa, Adriano Fernandes Teixeira, Cláudio Lima Souza, Lucas Miranda Marques, Guilherme Barretos Campos, Márcio Vasconcelos Oliveira, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Geovani Moreno Santos Júnior, Maria Teresa Araújo de Lorenzo Barcia, Renata de Amorim Marques, Hospital Geral de Vitória da Conquista, Vitória da Conquista 45030-160, Bahia, Brazil
Davi Tanajura Costa, Departamento de Ciências da Saúde, Universidade Estadual do Sudoeste da Bahia (UESB), Vitória da Conquista 45083-900, Bahia, Brazil
Dulciene Maria de Magalhães Queiroz, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
Author contributions: Lopes LW, Dórea RSDM, Araújo GRL, Silva FAFD, de Brito BB, and Cordeiro Santos ML contributed to laboratory processing of samples and data collection; Souza CL, Oliveira MV, Magalhães Queiroz DM, and Freire de Melo F contributed to development, supervision, and analysis of project stages; Lopes LW, Dórea RSDM, Araújo GRL, Silva FAFD, de Brito BB, Cordeiro Santos ML, Magalhães Queiroz DM, and Freire de Melo F contributed to project submission to the ethics committee and/or financial support; Silva FAFD, de Brito BB, and Cordeiro Santos ML wrote the article; Pinheiro FD, Júnior GMS, de Lorenzo Barcia MTA, Marques RA, Botelho AB, Dantas ACS, Costa DT, Teixeira AF, Marques LM, Campos GB contributed to reviewing and data analysis.
Supported by FAPEMIG Edital 001/2020 - Programa Emergencial de Apoio a Ações de Enfrentamento da Pandemia Causada pelo Novo Coronavírus. FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DA BAHIA – FAPESB, PPSUS - Programa Pesquisa para o SUS - Headline 02/2020, Term of Grant nº SUS0025/2021. Magalhães Queiroz DM, Freire de Melo F, are research fellows of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-) – Brazil. Programa Permanecer da Universidade Federal da Bahia. Programa Institucional de Bolsas de Iniciação Científica da Universidade Federal da Bahia (PIBIC-UFBA).
Institutional review board statement: This study was approved by the Ethics Committee from the Brazilian National Commission of Research Ethics (N. 4155234).
Clinical trial registration statement: We declare that this manuscript is not a clinical trial, and therefore a clinical trial registration is not needed.
Informed consent statement: The informed consent form was obtained from the relatives responsible for the enrolled patients.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All the data related to the research is available in the manuscript.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, MSc, PhD, Postdoc, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormínio Barros, 58, Candeias, Vitória da Conquista 45029-094, Bahia, Brazil. freiremelo@yahoo.com.br
Received: October 9, 2022
Peer-review started: October 9, 2022
First decision: October 24, 2022
Revised: November 19, 2022
Accepted: January 28, 2023
Article in press: January 28, 2023
Published online: March 16, 2023
Processing time: 148 Days and 9.6 Hours
ARTICLE HIGHLIGHTS
Research background

Coronavirus disease 2019 (COVID-19) has been a health concern around the world since it was first identified in 2019. An understanding of the epidemiological and clinical features related to the infection is very important for the development of prevention and treatment of the disease.

Research motivation

There is a lack of studies evaluating the clinical and epidemiological characteristics of patients with severe COVID-19 in the study region. Moreover, the data regarding the infection features in that population can contribute to the understanding of the disease.

Research objectives

The objectives were to describe epidemiological characteristics, signs, symptoms, and laboratory findings in individuals with severe COVID-19 from an intensive care unit in the state of Bahia in northeastern Brazil and to analyze predictive features for the disease outcomes.

Research methods

In this prospective, single-center study, 115 patients with severe COVID-19 admitted to an intensive care unit in northeastern Brazil were evaluated. Epidemiological, clinical, and laboratory data of the included patients were obtained. Clinical outcomes were monitored in the inpatient system.

Research results

The patients had a median age of 65.60 ± 15.78 years. Dyspnea was the most frequent symptom, affecting 73.9% of the patients, followed by cough (54.7%). Fever was reported in approximately one-third of patients and myalgia in 20.8% of patients. At least two comorbidities were found in 41.7% of the patients, and hypertension was the most prevalent one (57.3%). In addition, having two or more comorbidities was a predictor of mortality, and lower platelet count was positively associated with death as well. Nausea and vomiting were predictors of death, and the presence of a cough was a protective factor.

Research conclusions

This is the first report of a negative correlation between cough and death in severely ill severe acute respiratory syndrome coronavirus 2-infected individuals. The associations between comorbidities, advanced age, low platelet count, and the outcomes of the infection were similar to the results of previous studies, highlighting the relevance of these features.

Research perspectives

In future analyses, we will evaluate the role of various cytokine profiles in the inflammatory response in the population of this study. Moreover, the relationship between comorbidities and infection outcomes might be further explored in the next steps of the research.