Perfil epidemiológico e sobrevida de pacientes em tratamento hospitalar para COVID-19: um estudo de caso no interior da Amazônia

Abstract

Introduction: The disease caused by the novel coronavirus (SARS-CoV-2), COVID-19, has triggered until January 2022 more than 298 million cases and 5.47 million deaths worldwide. Brazil ranks 3rd in confirmed cases with more than 22.3 million infected and 2nd in number of deaths with more than 620,000 deaths. In Pará, more than 627,000 cases and 17,100 deaths were recorded, evidencing the high infectivity of this virus, whose primary route of contamination is the upper airways, with multiple systemic repercussions. Elderly people and people with chronic diseases are more likely to develop the severe form of the disease and its functional sequelae. Physiotherapeutic monitoring has been used in order to prevent losses in functionality and reduce hospitalization time. However, as it is a new disease, it is necessary to record, describe and understand the clinical-epidemiological and functional profile of patients who progress to hospitalization and to correlate these variables with the clinical outcome of patients. The objective of this research was to trace the clinical-epidemiological profile of patients hospitalized for the treatment of COVID-19 and to identify possible factors associated with survival, including the level of functionality. Methodology: An observational research was carried out where clinical and epidemiological data were collected from the medical records of patients hospitalized for treatment of COVID-19, from April 2020 to April 2021, at Hospital de Urgência e Emprego Drª Maria Laise Moreira Pereira Lima, located in the municipality of Castanhal-Pará. To assess functionality, the Modified Barthel Scale was used, which assesses the ability to perform activities of daily living. Descriptive statistics of central tendency and dispersion were used to describe the clinical-epidemiological profile, and later the Cox survival analysis, whose purpose is to study the occurrence of an event during a period of time. Statistical analyzes were performed using the SSPS software. Results: 880 patients were included according to the established criteria. The mean age was 54 years, of which 59.54% were male. The most frequently reported comorbidities were systemic arterial hypertension, diabetes and chronic kidney disease. According to a descriptive analysis, the group that did not have access to physical therapy seemed to have the worst outcomes, with 20.28% of deaths. Regarding functionality, all patients who presented some level of functional dependence required oxygen supplementation at some point. According to the survival analysis performed, the longer the hospitalization time, the greater the risk of death, and the factors that seemed to be decisive were age and number of associated comorbidities, and functional dependence, since patients with some impairment in functionality, were 2.75 times more likely to die. Conclusion: The risk of death increases in elderly patients, with two or more comorbidities and who have moderate, severe or total functional dependence. Knowing this, it is necessary to constantly monitor patients admitted to hospital units who present any of these risk factors.