ABSTRACT
Most people develop mild or moderate symptoms of COVID-19, but some people develop severe symptoms, leading to hospitalizations. The objective of the research was to analyze the prevalence of confirmed cases of COVID-19, hospitalization for this disease in Intensive Care Units, and the occupancy rate of beds resulting from the same in these units in the municipality of Rondonopolis, Mato Grosso. This was a cross-sectional, descriptive study with a quantitative approach, with data from secondary sources of epidemiological bulletins in Rondonopolis, Mato Grosso, from June 2020 to May 2021. The average number of hospitalized cases per month and the occupancy rate of intensive care beds were calculated. All cases reported with COVID-19 and hospitalized in the Intensive Care Unit of public hospitals in the municipality were included. Analyses were performed with R Software and the chi-square goodness-of-fit test and Kendall's correlation were performed. A total of 28,443 new cases of COVID-19 were reported during the study period, with the highest average of hospitalizations in the intensive care unit in the public health network was in May 2021 (n=51.1) and the bed occupancy rate was in September 2020 (129.17%). In all regions analyzed in comparison with this study, the ICUs operated in a state of calamity with high occupancy rates. A relationship between the increase in the number of cases and hospitalizations and occupancy rates of Intensive Care Units was identified, which are findings that indicate the need to control COVID-19. © 2022 Centro Universitario Sao Camilo. All rights reserved.
ABSTRACT
BACKGROUND: SARS-CoV-2 predisposes patients to secondary infections; however, a better understanding of the impact of coinfections on the outcome of hospitalized COVID-19 patients is still necessary. AIM: To analyse death risk due to coinfections in COVID-19 patients. METHODS: The odds of death of 212 severely ill COVID-19 patients were evaluated, with detailed focus on the risks for each pathogen, site of infection, comorbidities and length of hospitalization. FINDINGS: The mortality rate was 50.47%. Fungal and/or bacterial isolation occurred in 89 patients, of whom 83.14% died. Coinfected patients stayed hospitalized longer and had an increased odds of dying (odds ratio (OR): 13.45; R2 = 0.31). The risk of death was increased by bacterial (OR: 11.28) and fungal (OR: 5.97) coinfections, with increased levels of creatinine, leucocytes, urea and C-reactive protein. Coinfections increased the risk of death if patients suffered from cardiovascular disease (OR: 11.53), diabetes (OR: 6.00) or obesity (OR: 5.60) in comparison with patients with these comorbidities but without pathogen isolation. The increased risk of death was detected for coagulase-negative Staphylococcus (OR: 25.39), Candida non-albicans (OR: 11.12), S. aureus (OR: 10.72), Acinetobacter spp. (OR: 6.88), Pseudomonas spp. (OR: 4.77), and C. albicans (OR: 3.97). The high-risk sites of infection were blood, tracheal aspirate, and urine. Patients with coinfection undergoing invasive mechanical ventilation were 3.8 times more likely to die than those without positive cultures. CONCLUSION: Severe COVID-19 patients with secondary coinfections required longer hospitalization and had higher risk of death. The early diagnosis of coinfections is essential to identify high-risk patients and to determine the right interventions to reduce mortality.