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Acta Paulista De Enfermagem ; 33:9, 2020.
Article in English | Web of Science | ID: covidwho-1011957


Objective: To analyze the scientific evidence on palliative care implementation amidst the COVID-19 pandemic. Method: This is a scoping review based on the methodology proposed by the Joanna Briggs Institute. Virtual Health Library, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, EBSCO, Embase, PsycInfo (R) and Science Direct were analyzed using the descriptors "palliative care" and "coronavirus" and the keyword "COVID-19". Thirty studies were selected for analysis. Results: This review showed strategies for palliative care implementation using protocols and telemedicine, to facilitate communication, and showed how palliative therapy approach has been, revealing the need to promote comfort and welcoming patients and family members in times of pain and grief. Conclusion: The palliative care principles contribute to comprehensive care, but its implementation amidst the crisis is a challenge. It is important to provide conditions to apply it in the daily life of health services, even in pandemic scenarios.

Epidemiol Infect ; 148: e123, 2020 06 25.
Article in English | MEDLINE | ID: covidwho-615328


This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.

Coronavirus Infections/mortality , Pneumonia, Viral/mortality , Adult , Age Factors , Aged , Brazil/epidemiology , COVID-19 , Cardiovascular Diseases/complications , Cohort Studies , Comorbidity , Coronavirus Infections/complications , Diabetes Complications/complications , Female , Hospitalization , Humans , Intensive Care Units , Kaplan-Meier Estimate , Kidney Diseases/complications , Lung Diseases/complications , Male , Middle Aged , Nervous System Diseases/complications , Pandemics , Pneumonia, Viral/complications , Poisson Distribution , Proportional Hazards Models , Risk Factors , Sex Factors , Time Factors