ABSTRACT
Introduction. Patients with chronic kidney disease (CKD) and COVID-19 are at high risk of adverse outcomes due to the presence of comorbidities. However, it is still unclear whether dialysis therapy is associated with a worse prognosis in patients infected with SARSCoV- 2. The objectives were to assess mortality and risk factors associated with a worse prognosis of these patients (e.g., age, sex, comorbidities, Intensive Care Admission [ICU] admission, and need for invasive mechanical ventilation [IMV]). Methods. An observational, descriptive, retrospective study was conducted in the private healthcare maintenance organization (Unimed-BH) of Belo Horizonte and 33 surrounding cities in Brazil. We used data collected from the organization's database. We included adult inpatients with CKD on previous dialysis therapy who tested positive for COVID-19, from February 2020 to June 2021. Results. During the period, 16182 patients were admitted to Unimed-BH with a diagnosis of COVID-19. Of these, 333 (2%) had dialysis CKD. Male patients were 180 (54%), age ranged from 22.85 to 95.75 years and the mean was 60.91 years. Of the 333 patients, 109 (32.7%) were admitted to the ICU, and 56 (16.8%) required IMV. Among the 14 comorbidities analysed, the mean number of comorbidities was 6, with 93 (27.9%) dyslipidaemia, 74 (22%) diabetic, 270 (81%) hypertensive, 25 (7.5%) asthmatic, 42 (12.6%) with chronic pulmonary disease (CPD) and 122 (36.6%) with congestive heart failure (CHF). There were 66 (19.8%) deaths, 29 (43.9%) were male, the mean age was 60.8 years, and 23 patients (34.8%) were elderly (>60 years). Among the patients who died, 55 (83.3%) were in the ICU and 46 (69.7%) on IMV. The mean number of comorbidities was 9.27 being 16 (24.2%) dyslipidaemia, 44 (66.6%) diabetic, 60 (90.9%) hypertensive, 5 (7%) asthmatic, 10 (15%) with CPD and 32 (48.5%) with CHF. Conclusions. Dialysis patients appear more susceptible to unfavourable outcomes than the general population. Our findings are similar to those reported in the world literature which is still scarce. It is important to conduct more studies on this population.
ABSTRACT
Introduction. Life expectancy is increasing worldwide. However, during the COVID-19 pandemic, people 100 years or more (centenaries) were challenged by a potentially fatal disease. We evaluated the outcome of centenaries hospitalized due to COVID-19 in a private healthcare system of Belo Horizonte/Brazil (Unimed-BH). Methods. Administrative data were collected from the hospital database. Patients were included if they had a severe adult respiratory syndrome due to coronavirus type 2 (SARS-CoV-2) ribonucleic acid identified by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) or by the International Code of Disease- 10th review (ICD-10) hospitalization codes U07.1, B34.2, or B97.2. Results. From March 1 2020 to October 31 2021, 316.4 & plusmn;12.9 centenaries/month were registered. Eighteen hospitalizations due to COVID-19 were identified. Median age was 101.8 years (interquartile range [IQR]:100.7,103.0). Most patients were female (83%). There was a median of 6.0 morbidities per patient (IQR:5.3,7.8), range 2-12 morbidities, among 71 possible morbidities. The most described morbidities were systemic arterial hypertension (94%), dementia (61%), and congestive heart failure (61%). Median length of hospitalization was 6.5 days (IQR:3.3,8.0). No patient was dialyzed. Seven (39%) patients died during hospitalization, of whom 3 (17%) were admitted to the Intensive Care Unit and 2 (11%) were oxygenated by invasive mechanical ventilation. No other patients were admitted to the Intensive Care Unit or invasively mechanically ventilated. Conclusions. Although the hospitalization rate was low, the mortality rate during hospitalization was high among centenaries. Further research is required to evaluate the actual risks of centenaries to be infected by SARS-CoV-2 and the subsequent outcomes.
ABSTRACT
This article aims to identify the possibilities of the diaconal action of the Evangelical Church of Lutheran Confession in Brazil-IECLB in face of the crisis caused by COVID-19, which is taking place and which will bring relevant consequences for the socio-political context in the Country. At the beginning of the article, there is a report of the diaconal experience of the Sinodo Nordeste Gaucho and its way of acting in the 2020 pandemic situation. Based on a reflection on the relationship between crisis and transforming diakonia, the article returns to the origins and facts of the diaconal history of the IECLB, demonstrating how the church and it's Diakonia has acted in these difficult times that have already occurred.
ABSTRACT
Objective: To describe the psychosocial impact caused by the pandemic of the new coronavirus on health professionals. Method: This is a narrative review carried out on the Virtual Health Library platform using the following descriptors "Health Professionals" AND "COVID-19", from May to June 2020. Results: A chart was developed showing the characteristics of the six selected scientific articles, according to title, authors, year of publication, journal, type of study and psychosocial impact. Conclusion: In the midst of the pandemic, professionals may feel helpless, overloaded with activities and severely affected physically and psychologically, becoming more vulnerable. There is need to adopt protective measures and a psychosocial action plan to provide better working conditions, medical care, psychological and therapeutic care, promoting qualifications and the use of integrative and complementary health practices. © 2021 Universidade Federal da Bahia. All rights reserved.