Mortality predictors in a cohort of patients with COVID-19 admitted to a large tertiary hospital in the city of São Paulo, Brazil: a retrospective study

Abstract

INTRODUCTIONCoronavirus disease (COVID-19) is a potentially fatal infection caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that was first reported in the city of Wuhan, China, in December 2019. Since then, the disease has achieved a pandemic status, assuming dramatic proportions, thus leading to a global public health emergency. [1][2][3] In Brazil, the first case was officially confirmed on February 26, 2020, in the city of São Paulo, which has remained the epicenter of the country's pandemic with the third highest total number of confirmed cases. 4,5 Reports issued by the World Health Organization (WHO) on July 31, 2020, show that there is a significant difference in prognoses across countries, with a case fatality rate of the disease ranging between 3.53% (90,134/2,552,265 cases) in Brazil, 3.42% (150,054/4,388,566 cases) in the United States of America, and 14.21% (35,132/247,158 cases) in Italy. The reasons for such discrepancies remain to be fully elucidated, with population and genetic aspects, epidemiological control, population testing, and local management of the pandemic seeming to contribute to this situation. 6 Moreover, in Brazil, approximately 70% of the population relied solely on the services of its National Healthcare System (known as the "Unified Health System, " or by its acronym in Portuguese: SUS, Sistema Único de Saúde), 7 which rapidly led to hospital overcapacity and, therefore, possible preventable fatalities. In addition, hospitalization is known to have an array of negative impacts on the overall health of patients, such as secondary infections, needless procedures, psychological distress, and economic fallout of the health system that covers most of the nation's population.

Clinical outcomes in newborns of pregnant women with COVID-19: integrative review

“…Nurses working in maternal-child care play a critical role in managing pregnant women with COVID-19 and caring for newborns affected by the infection ( 30 - 31 , 34 - 38 ) . Adaptability, continuous updating, and an understanding of clinical nuances are essential for providing quality care, both in Brazil and globally, as we face the challenges posed by the COVID-19 pandemic and the post-pandemic era ( 32 - 38 ) .…”

“…Nurses need to be well aware of potential neonatal outcomes in cases where pregnant women contract COVID-19 and use the lessons learned to apply them to other populations. Understanding the prevalence of different outcomes is vital for nursing professionals, empowering them to provide the necessary care and support to populations ( 32 - 40 ) .…”