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Cross-sectional study for COVID-19-related mortality predictors in a Brazilian state-wide landscape: the role of demographic factors, symptoms and comorbidities.
Gustani-Buss, Emanuele Gustani; Buss, Carlos E; Cavalli, Luciane R; Panis, Carolina; Tuon, Felipe F; Telles, Joao P; Follador, Franciele A C; Wendt, Guilherme W; Lucio, Léia C; Ferreto, Lirane E D; de Oliveira, Isabela M; Carraro, Emerson; David, Lualis E; Simão, Andréa N C; Boldt, Angelica B W; Luiza Petzl-Erler, Maria; Silva, Wilson A; Figueiredo, David L A.
  • Gustani-Buss EG; Bioinformatics Laboratory, Institute for Cancer Research, IPEC, Guarapuava, Brazil emanuelebuss@unicentro.br.
  • Buss CE; Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
  • Cavalli LR; New Arrangements for Research and Innovation - Genomics-Novos Arranjos de Pesquisa e Inovação - Genômica (NAPI-Genômica), Araucária Foundation - FAAP-PR, Curitiba, Parana, Brazil.
  • Panis C; Bioinformatics Laboratory, Institute for Cancer Research, IPEC, Guarapuava, Brazil.
  • Tuon FF; New Arrangements for Research and Innovation - Genomics-Novos Arranjos de Pesquisa e Inovação - Genômica (NAPI-Genômica), Araucária Foundation - FAAP-PR, Curitiba, Parana, Brazil.
  • Telles JP; MindFlow Genomics, Guarapuava, Brazil.
  • Follador FAC; Postgraduate Program in Biotechnology Applied to Child and Adolescent Health at FPP, Faculdades Pequeno Príncipe, Curitiba, Brazil.
  • Wendt GW; Laboratory of Tumor Biology, Western Paraná State University-UNIOESTE, Cascavel, Brazil.
  • Lucio LC; Laboratory of Emerging Infectious Diseases, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
  • Ferreto LED; Laboratory of Emerging Infectious Diseases, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
  • de Oliveira IM; Department of Life Sciences,Postgraduate Program in Applied Health Sciences, Western Paraná State University-UNIOESTE, Francisco Beltrão, Brazil.
  • Carraro E; Department of Life Sciences,Postgraduate Program in Applied Health Sciences, Western Paraná State University-UNIOESTE, Francisco Beltrão, Brazil.
  • David LE; Department of Life Sciences,Postgraduate Program in Applied Health Sciences, Western Paraná State University-UNIOESTE, Francisco Beltrão, Brazil.
  • Simão ANC; Department of Life Sciences,Postgraduate Program in Applied Health Sciences, Western Paraná State University-UNIOESTE, Francisco Beltrão, Brazil.
  • Boldt ABW; New Arrangements for Research and Innovation - Genomics-Novos Arranjos de Pesquisa e Inovação - Genômica (NAPI-Genômica), Araucária Foundation - FAAP-PR, Curitiba, Parana, Brazil.
  • Luiza Petzl-Erler M; Institute for Cancer Research IPEC, Guarapuava, Brazil.
  • Silva WA; New Arrangements for Research and Innovation - Genomics-Novos Arranjos de Pesquisa e Inovação - Genômica (NAPI-Genômica), Araucária Foundation - FAAP-PR, Curitiba, Parana, Brazil.
  • Figueiredo DLA; Virology Laboratory, Midwestern Parana State University-UNICENTRO, Guarapuava, Brazil.
BMJ Open ; 12(10): e056801, 2022 10 17.
Article in English | MEDLINE | ID: covidwho-2078939
ABSTRACT

OBJECTIVE:

The Brazilian state of Paraná has suffered from COVID-19 effects, understanding predictors of increased mortality in health system interventions prevent hospitalisation of patients. We selected the best models to evaluate the association of death with demographic characteristics, symptoms and comorbidities based on three levels of clinical severity for COVID-19 non-hospitalised, hospitalised non-ICU ward and ICU ward.

DESIGN:

Cross-sectional survey using binomial mixed models.

SETTING:

COVID-19-positive cases diagnosed by reverse transcription-PCR of municipalities located in Paraná State. PATIENTS Cases of anonymous datasets of electronic medical records from 1 April 2020 to 31 December 2020. PRIMARY AND SECONDARY OUTCOME

MEASURES:

The best prediction factors were chosen based on criteria after a stepwise analysis using multicollinearity measure, lower Akaike information criterion and goodness-of-fit χ2 tests from univariate to multivariate contexts.

RESULTS:

Male sex was associated with increased mortality among non-hospitalised patients (OR 1.76, 95% CI 1.47 to 2.11) and non-ICU patients (OR 1.22, 95% CI 1.05 to 1.43) for symptoms and for comorbidities (OR 1.89, 95% CI 1.59 to 2.25, and OR 1.30, 95% CI 1.11 to 1.52, respectively). Higher mortality occurred in patients older than 35 years in non-hospitalised (for symptoms OR 4.05, 95% CI 1.55 to 10.54; and for comorbidities OR 3.00, 95% CI 1.24 to 7.27) and in hospitalised over 40 years (for symptoms OR 2.72, 95% CI 1.08 to 6.87; and for comorbidities OR 2.66, 95% CI 1.22 to 5.79). Dyspnoea was associated with increased mortality in non-hospitalised (OR 4.14, 95% CI 3.45 to 4.96), non-ICU (OR 2.41, 95% CI 2.04 to 2.84) and ICU (OR 1.38, 95% CI 1.10 to 1.72) patients. Neurological disorders (OR 2.16, 95% CI 1.35 to 3.46), neoplastic (OR 3.22, 95% CI 1.75 to 5.93) and kidney diseases (OR 2.13, 95% CI 1.36 to 3.35) showed the majority of increased mortality for ICU as well in the three levels of severity jointly with heart disease, diabetes and CPOD.

CONCLUSIONS:

These findings highlight the importance of the predictor's assessment for the implementation of public healthcare policy in response to the COVID-19 pandemic, mainly to understand how non-pharmaceutical measures could mitigate the virus impact over the population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: South America / Brazil Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-056801

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: South America / Brazil Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-056801