ABSTRACT
INTRODUCTION: Since the onset of the pandemic, COVID-19 has affected the entire world population, however, data on child morbidity and mortality are scarce. This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of Brazilian children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19. METHODOLOGY: This cross-sectional study uses public domain data from the Influenza Epidemiological Surveillance System in 2021. The prevalence rates, lethality, and duration of hospitalization of children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19 were analyzed. Logistic regression and adjusted Odds Ratio were used. A p < 0.05 was considered significant. RESULTS: The prevalence of hospitalization among children and adolescents was 3.6%, and the case lethality rate was 4.0%. Higher lethality rates occurred among adolescents, natives, rural residents, those living in Brazil's northern and northeastern regions, and those who became critically ill and had comorbidities. Hospitalization time was longer for adolescents who became critically ill or had comorbidities. The highest chance of death was associated with: children under one year of age and adolescents, natives, and residents from the North, Northeast, and Southeast regions, who became critically ill and had comorbidities. CONCLUSIONS: Despite lower hospitalization and death rates than adults, the prevalence, complications, and mortality from COVID-19 in the pediatric population are relevant. Knowledge of the profile of children and adolescents hospitalized due to COVID-19 and the factors associated with these deaths allows the guidance of response efforts directed to assist this vulnerable population.
Subject(s)
COVID-19 , Adult , Humans , Child , Adolescent , COVID-19/epidemiology , Brazil/epidemiology , SARS-CoV-2 , Cross-Sectional Studies , Critical Illness , HospitalizationABSTRACT
OBJETIVO: Identificar la carga de trabajo de enfermería requerida por pacientes adultos durante su estadía en una UCI y en relación con el desenlace clínico. MÉTODOS: Estudio de cohorte prospectivo realizado con 53 pacientes hospitalizados en una UCI de adultos entre julio y septiembre de 2018. Se utilizó el Nursing Activities Score (NAS) para la recopilación de datos. Se emplearon estadísticas descriptivas e inferenciales para comparar los promedios. Se consideró el valor de p < 0,05 como significativo. Este estudio fue aprobado por el Comité de Ética en Investigación (Opinión 2.014.344). RESULTADOS: Hubo un predominio de pacientes del género femenino (28-52,83%), con edades comprendidas entre 17 y 96 años, procedentes del servicio de urgencia/emergencia (34-65,38%), debido a enfermedades del sistema circulatorio (18-33,96%). La severidad promedio por el SAPS 3 fue de 52,32 puntos y la estimación de mortalidad fue de 25,34%. La duración de la estancia hospitalaria osciló entre 2 y 38 días y prevaleció el alta de los pacientes (39-73,58%). El promedio de NAS fue de 57,41%, equivalente a 13,78 horas de atención de enfermería, durante un período de 24 horas. La carga de trabajo de enfermería promedio al momento de la entrada fue mayor que el promedio medido al momento del desenlace clínico (p < 0,001). Los pacientes que progresaron a la muerte durante la hospitalización tuvieron un puntaje NAS promedio más alto que el de los pacientes que sobrevivieron (p = 0,022). CONCLUSIONES: La carga de trabajo de enfermería osciló durante el período de estancia hospitalaria, siendo mayor el primer día de hospitalización y en la atención de pacientes con un pronóstico reservado (muerte)
OBJECTIVE: To identify the nursing workload required by adult patients during hospitalization in an Intensive Care Unit (ICU) and in relation to the clinical outcome. METHODS: Prospective cohort with 53 patients admitted to an adult ICU between July and September 2018. The Nursing Activities Score (NAS) was used for data collection. Descriptive and inferential statistics were used to compare means. The value of p < 0.05 was considered significant. This study was approved by the Research Ethics Committee (Opinion 2,014,344). RESULTS: There was a predominance of female patients (28 - 52.83%), aged between 17 and 96 years, from the urgency/emergency service (34 - 65.38%), and admitted due to diseases of the circulatory system (18 - 33.96%). The severity of patients according to the SAPS 3 score was 52.32 points and the estimated mortality was of 25.34%. The length of hospital stay ranged from 2 to 38 days and discharge prevailed among the outcomes (39 - 73.58%). The average NAS was 57.41%, equivalent to 13.78 hours of nursing care in a 24-hour period. The average nursing workload at admission was higher than the average measured at the time of clinical outcome (p < 0.001). Patients who died during hospitalization had an average NAS higher than that of patients who survived (p = 0.022). CONCLUSIONS: The nursing workload varied over the hospitalization period, being greater on the first day of hospitalization and in the care of patients with a poor prognosis (death)
OBJETIVO: Identificar a carga de trabalho da enfermagem requerida por pacientes adultos durante a internação em uma UTI e em relação ao desfecho clínico. MÉTODOS: Coorte prospectiva realizada com 53 pacientes internados em uma UTI de adultos entre julho e setembro de 2018. Utilizou-se o Nursing Activities Score (NAS) para a coleta de dados. Realizou-se a estatística descritiva e inferencial para comparação de médias. Considerou-se como significativo o valor de p <0,05. Este estudo obteve foi aprovado pelo Comitê de Ética em Pesquisa (Parecer 2.014.344). RESULTADOS: Houve predomínio de pacientes do sexo feminino (28 - 52,83%), com idade entre 17 e 96 anos, proveniente do serviço de urgência/emergência (34 - 65,38%), devido a doenças do aparelho circulatório (18 - 33,96%). A gravidade pelo SAPS 3 média foi de 52,32 pontos e estimativa de mortalidade de 25,34%. O tempo de internação variou de 2 a 38 dias e a alta dos pacientes prevaleceu (39 - 73,58%). A média do NAS foi de 57,41%, equivalendo-se a 13,78 horas de assistência de enfermagem, no período de 24 horas. A média da carga de trabalho da enfermagem no momento da admissão foi maior que a média mensurada no momento do desfecho clínico (p < 0,001). Os pacientes que evoluíram para o óbito durante a internação apresentaram uma pontuação média no score NAS superior à dos pacientes que sobreviveram (p = 0,022). CONCLUSÕES: A carga de trabalho da enfermagem variou ao longo do período de internação sendo maior no primeiro dia de internação e no cuidado dos pacientes com prognóstico reservado (óbito)
