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2.
Clinics (Sao Paulo) ; 76: e3488, 2021.
Article in English | MEDLINE | ID: covidwho-1547645

ABSTRACT

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.


Subject(s)
COVID-19 , Adolescent , COVID-19/complications , Child , Cohort Studies , Cross-Sectional Studies , Humans , Infant, Newborn , SARS-CoV-2 , Systemic Inflammatory Response Syndrome , Tertiary Care Centers
3.
BMJ Open ; 11(6): e051706, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1290077

ABSTRACT

INTRODUCTION: COVID-19 may lead to persistent and potentially incapacitating clinical manifestations (post-acute sequelae of SARS-CoV-2 infection (PASC)). Using easy-to-apply questionnaires and scales (often by telephone interviewing), several studies evaluated samples of COVID-19 inpatients from 4 weeks to several months after discharge. However, studies conducting systematic multidisciplinary assessments of PASC manifestations are scarce, with thorough in-person objective evaluations restricted to modestly sized subsamples presenting greatest disease severity. METHODS AND ANALYSES: We will conduct a prospective observational study of surviving individuals (above 18 years of age) from a cohort of over 3000 subjects with laboratory-confirmed COVID-19 who were treated as inpatients at the largest academic health centre in Sao Paulo, Brazil (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo). All eligible subjects will be consecutively invited to undergo a 1-2-day series of multidisciplinary assessments at 2 time-points, respectively, at 6-9 months and 12-15 months after discharge. Assessment schedules will include detailed multidomain questionnaires applied by medical research staff, self-report scales, objective evaluations of cardiopulmonary functioning, physical functionality and olfactory status, standardised neurological, psychiatric and cognitive examinations, as well as diagnostic laboratory, muscle ultrasound and chest imaging exams. Remaining material from blood tests will be incorporated by a local biobank for use in future investigations on inflammatory markers, genomics, transcriptomics, peptidomics and metabolomics. ETHICS AND DISSEMINATION: All components of this programme have been approved by local research ethics committees. We aim to provide insights into the frequency and severity of chronic/post-COVID multiorgan symptoms, as well as their interrelationships and associations with acute disease features, sociodemographic variables and environmental exposures. Findings will be disseminated in peer-reviewed journals and at scientific meetings. Additionally, we aim to provide a data repository to allow future pathophysiological investigations relating clinical PASC features to biomarker data extracted from blood samples. TRIAL REGISTRATION NUMBER: RBR-8z7v5wc; Pre-results.


Subject(s)
COVID-19 , SARS-CoV-2 , Brazil , COVID-19/complications , Hospitalization , Humans , Observational Studies as Topic
5.
Ferreira, Juliana C.; Ho, Yeh-Li, Besen, Bruno A. M. P.; Malbuisson, Luiz M. S.; Taniguchi, Leandro U.; Mendes, Pedro V.; Costa, Eduardo L. V.; Park, Marcelo, Daltro-Oliveira, Renato, Roepke, Roberta M. L.; Silva Jr, João M.; Carmona, Maria José C.; Carvalho, Carlos Roberto Ribeiro, Hirota, Adriana, Kanasiro, Alberto Kendy, Crescenzi, Alessandra, Fernandes, Amanda Coelho, Miethke-Morais, Anna, Bellintani, Arthur Petrillo, Canasiro, Artur Ribeiro, Carneiro, Bárbara Vieira, Zanbon, Beatriz Keiko, Batista, Bernardo Pinheiro De Senna Nogueira, Nicolao, Bianca Ruiz, Besen, Bruno Adler Maccagnan Pinheiro, Biselli, Bruno, Macedo, Bruno Rocha De, Toledo, Caio Machado Gomes De, Pompilio, Carlos Eduardo, Carvalho, Carlos Roberto Ribeiro De, Mol, Caroline Gomes, Stipanich, Cassio, Bueno, Caue Gasparotto, Garzillo, Cibele, Tanaka, Clarice, Forte, Daniel Neves, Joelsons, Daniel, Robira, Daniele, Costa, Eduardo Leite Vieira, Silva Júnior, Elson Mendes Da, Regalio, Fabiane Aliotti, Segura, Gabriela Cardoso, Marcelino, Gustavo Brasil, Louro, Giulia Sefrin, Ho, Yeh-Li, Ferreira, Isabela Argollo, Gois, Jeison de Oliveira, Silva Junior, Joao Manoel Da, Reusing Junior, Jose Otto, Ribeiro, Julia Fray, Ferreira, Juliana Carvalho, Galleti, Karine Vusberg, Silva, Katia Regina, Isensee, Larissa Padrao, Oliveira, Larissa dos Santos, Taniguchi, Leandro Utino, Letaif, Leila Suemi, Lima, Lígia Trombetta, Park, Lucas Yongsoo, Chaves Netto, Lucas, Nobrega, Luciana Cassimiro, Haddad, Luciana, Hajjar, Ludhmila, Malbouisson, Luiz Marcelo, Pandolfi, Manuela Cristina Adsuara, Park, Marcelo, Carmona, Maria José Carvalho, Andrade, Maria Castilho Prandini H. De, Santos, Mariana Moreira, Bateloche, Matheus Pereira, Suiama, Mayra Akimi, Oliveira, Mayron Faria de, Sousa, Mayson Laercio, Louvaes, Michelle, Huemer, Natassja, Mendes, Pedro, Lins, Paulo Ricardo Gessolo, Santos, Pedro Gaspar Dos, Moreira, Pedro Ferreira Paiva, Guazzelli, Renata Mello, Reis, Renato Batista Dos, Oliveira, Renato Daltro De, Roepke, Roberta Muriel Longo, Pedro, Rodolpho Augusto De Moura, Kondo, Rodrigo, Rached, Samia Zahi, Fonseca, Sergio Roberto Silveira Da, Borges, Thais Sousa, Ferreira, Thalissa, Cobello Junior, Vilson, Sales, Vivian Vieira Tenório, Ferreira, Willaby Serafim Cassa, Group, E. PICCoV Study.
Clinics ; 75:e2294-e2294, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742344

ABSTRACT

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

6.
Ferreira, Juliana C; Ho, Yeh-Li; Besen, Bruno A M P; Malbuisson, Luiz M S; Taniguchi, Leandro U; Mendes, Pedro V; Costa, Eduardo L V; Park, Marcelo; Daltro-Oliveira, Renato; Roepke, Roberta M L; Silva Jr, João M; Carmona, Maria José C; Carvalho, Carlos Roberto Ribeiro; Hirota, Adriana; Kanasiro, Alberto Kendy; Crescenzi, Alessandra; Fernandes, Amanda Coelho; Miethke-Morais, Anna; Bellintani, Arthur Petrillo; Canasiro, Artur Ribeiro; Carneiro, Bárbara Vieira; Zanbon, Beatriz Keiko; Batista, Bernardo Pinheiro De Senna Nogueira; Nicolao, Bianca Ruiz; Besen, Bruno Adler Maccagnan Pinheiro; Biselli, Bruno; Macedo, Bruno Rocha De; Toledo, Caio Machado Gomes De; Pompilio, Carlos Eduardo; Carvalho, Carlos Roberto Ribeiro De; Mol, Caroline Gomes; Stipanich, Cassio; Bueno, Caue Gasparotto; Garzillo, Cibele; Tanaka, Clarice; Forte, Daniel Neves; Joelsons, Daniel; Robira, Daniele; Costa, Eduardo Leite Vieira; Silva Júnior, Elson Mendes Da; Regalio, Fabiane Aliotti; Segura, Gabriela Cardoso; Marcelino, Gustavo Brasil; Louro, Giulia Sefrin; Ho, Yeh-Li; Ferreira, Isabela Argollo; Gois, Jeison de Oliveira; Silva Junior, Joao Manoel Da; Reusing Junior, Jose Otto; Ribeiro, Julia Fray; Ferreira, Juliana Carvalho; Galleti, Karine Vusberg; Silva, Katia Regina; Isensee, Larissa Padrao; Oliveira, Larissa dos Santos; Taniguchi, Leandro Utino; Letaif, Leila Suemi; Lima, Lígia Trombetta; Park, Lucas Yongsoo; Chaves Netto, Lucas; Nobrega, Luciana Cassimiro; Haddad, Luciana; Hajjar, Ludhmila; Malbouisson, Luiz Marcelo; Pandolfi, Manuela Cristina Adsuara; Park, Marcelo; Carmona, Maria José Carvalho; Andrade, Maria Castilho Prandini H De; Santos, Mariana Moreira; Bateloche, Matheus Pereira; Suiama, Mayra Akimi; Oliveira, Mayron Faria de; Sousa, Mayson Laercio; Louvaes, Michelle; Huemer, Natassja; Mendes, Pedro; Lins, Paulo Ricardo Gessolo; Santos, Pedro Gaspar Dos; Moreira, Pedro Ferreira Paiva; Guazzelli, Renata Mello; Reis, Renato Batista Dos; Oliveira, Renato Daltro De; Roepke, Roberta Muriel Longo; Pedro, Rodolpho Augusto De Moura; Kondo, Rodrigo; Rached, Samia Zahi; Fonseca, Sergio Roberto Silveira Da; Borges, Thais Sousa; Ferreira, Thalissa; Cobello Junior, Vilson; Sales, Vivian Vieira Tenório; Ferreira, Willaby Serafim Cassa.
Clinics ; 75: e2294, 2020. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-769762

ABSTRACT

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Research Design , Brazil , Cohort Studies , Hospital Mortality , Observational Studies as Topic , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19 , Hospitals, University , Intensive Care Units
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