COVID-19 is a disease whose knowledge is still under construction, high transmissibility, with no consensual treatment available to everyone. Therefore, the identification of patients at higher risk of evolving to the critical form of the disease is fundamental. The study aimed to determine risk factors associated with the severity of COVID-19 in adults patients. This is an observational, retrospective study from a cohort of adult patients with COVID-19 admitted to a public hospital from March to August 2020, whose medical records were evaluated. For the association of possible severity predictors, a Poisson regression was used. The primary outcome was the critical form of the disease (need for admission to the Intensive Care Unit and/or invasive mechanical ventilation). We included 565 patients: mostly men; 55.5% of those who progressed to the critical form of the disease were over sixty years old. Hypertension, diabetes mellitus and obesity were the most frequent comorbidities. There were 39.8% of patients who progressed to the critical form of the disease. The hospital mortality rate was 22.1%, and that of critical patients was 46.7%. The independent factors associated with the severity of the disease were obesity [RR = 1.33 (95% CI 1.07 to 1.66; p = 0.011)], SpO 2 /FiO 2 ratio ≤ 315 [RR = 2.20 (95% CI 1.79 to 2.71; p = 0.000)], C-reactive protein > 100 mg/L [RR = 1.65 (95% CI 1.33 to 2.06; p = 0.000)], and lymphocytes < 1,000/µL [RR = 1.44 (95% CI 1.18 to 1.75; p = 0.000)]. Advanced age and comorbidities were dependent factors strongly associated with the critical form of the disease.

Objective: to analyze the expressions of spirituality and religiosity of relatives of people who abuse or are dependent on psychoactive substances. Methods: exploratory-descriptive research that dialogues with the spirituality and religiosity conceptual framework. It was performed at an outpatient clinic specialized in drug treatment in southern Brazil. Semi-structured interviews conducted with 11 relatives of patients undergoing treatment were analyzed by content analysis. Results: the findings were grouped into two categories: forms of expression of spirituality and religiosity practices; and their influence on relatives’ lives. Spirituality and religiosity almost always serve as a protective factor against feelings of anguish, conflicts and loneliness. Final considerations: despite the important role of expressions of spirituality and religiosity for many relatives, not everyone seems to benefit from them. Health professionals should consider these expressions in the construction of comprehensive health care for relatives.

Análise dos custos dA internAção hospitAlAr de pAcientes em ventilAção mecânicA invAsivA e fAtores AssociAdos AnAlysis of hospitAlizAtion costs of pAtients receiving invAsive mechAnicAl ventilAtion And AssociAted fActors

Relatar o caso do paciente zero da COVID-19 atendido em uma Unidade de Terapia Intensiva referência de um hospital público do Sul do Brasil. Estudo qualitativo, observacional, descritivo, do tipo relato de caso. Paciente de 30 anos, sexo masculino, portador de asma leve, evoluiu para Síndrome do Desconforto Respiratório Aguda grave, necessitando de extenso tempo de suporte ventilatório mecânico, com elevadas doses de sedoanalgesia e bloqueador neuromuscular, além de manobra de prona e uso de drogas vasoativas. Passou por longa reabilitação e recebeu alta hospitalar após 45 dias de internação. Relato do primeiro caso de COVID-19 atendido em uma UTI de um hospital público. Um paciente jovem que evoluiu rapidamente para a forma grave da doença, necessitando de longo período em cuidados intensivos. Esta descrição de caso contribui para o conhecimento acerca da patologia e assistência necessária aos pacientes acometidos pela COVID-19.Descritores: Infecções por Coronavírus, Síndrome do Desconforto Respiratório do Adulto, Unidade de Terapia Intensiva. COVID-19 patient zero assistance in a public intensive care unitAbstract: To report the case of patient COVID-19 treated at an intensive care unit, a reference in a public hospital in southern Brazil. Qualitative, observational, descriptive, case report type study. A 30-year-old male patient with mild asthma progressed to severe acute respiratory distress syndrome, requiring extensive time on mechanical ventilatory support, with high doses of sedoanalgesia and neuromuscular blocker, in addition to prone maneuver and use of vasoactive drugs. He underwent long rehabilitation and was discharged after 45 days of hospitalization. Report of the first case of COVID-19 seen in an ICU of a public hospital. A young patient who quickly evolved to the severe form of the disease, requiring long-term intensive care. This case description contributes to the knowledge about the pathology and necessary assistance to patients affected by COVID-19.Descriptors: Coronavirus Infections, Respiratory Distress Syndrome Adult, Intensive Care Units. Paciente cero de COVID-19 atendido en unidad de cuidados intensivosResumen: Informar el caso del paciente cero de COVID-19 atendido en una unidad de cuidados intensivos, referente en un hospital público del sur de Brasil. Estudio cualitativo, observacional, descriptivo, tipo reporte de caso. Hombre de 30 años con asma leve que evolucionó a la síndrome de dificultad respiratoria aguda severo, requiriendo un tiempo prolongado de soporte ventilatorio mecánico, con altas dosis de sedoanalgesia y bloqueador neuromuscular, además de maniobra en decúbito prono y uso de fármacos vasoactivos. Fue sometido a una larga rehabilitación y recibió alta del hospital después de 45 días de hospitalización. Reporte del primer caso de COVID-19 atendido en una UCI de un hospital público. Paciente joven que evolucionó rápidamente a la forma grave de la enfermedad, requiriendo cuidados intensivos a largo plazo. Esta descripción de caso contribuye al conocimiento sobre la patología y la asistencia necesaria a los pacientes afectados por COVID-19.Descriptores: Infecciones por Coronavirus, Síndrome de Dificultad Respiratoria del Adulto, Unidades de Cuidados Intensivos.

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