On the analysis of mortality risk factors for hospitalized COVID-19 patients: A data-driven study using the major Brazilian database

Abstract

Background Brazil became the epicenter of the COVID-19 epidemic in a brief period of a few months after the first officially registered case. The knowledge of the epidemiological/clinical profile and the risk factors of Brazilian COVID-19 patients can assist in the decision making of physicians in the implementation of early and most appropriate measures for poor prognosis patients. However, these reports are missing. Here we present a comprehensive study that addresses this demand. Methods This data-driven study was based on the Brazilian Ministry of Health Database (SIVEP-Gripe) regarding notified cases of hospitalized COVID-19 patients during the period from February 26th to August 10th, 2020. Demographic data, clinical symptoms, comorbidities and other additional information of patients were analyzed. Results The hospitalization rate was higher for male gender (56.56%) and for older age patients of both sexes. Overall, the lethality rate was quite high (41.28%) among hospitalized patients, especially those over 60 years of age. Most prevalent symptoms were cough, dyspnoea, fever, low oxygen saturation and respiratory distress. Cardiac disease, diabetes, obesity, kidney disease, neurological disease, and pneumopathy were the most prevalent comorbidities. A high prevalence of hospitalized COVID-19 patients with cardiac disease (65.7%) and diabetes (53.55%) and with a high lethality rate of around 50% was observed. The intensive care unit (ICU) admission rate was 39.37% and of these 62.4% died. 24.4% of patients required invasive mechanical ventilation (IMV), with high mortality among them (82.98%). The main mortality risk predictors were older age and IMV requirement. In addition, socioeconomic conditions have been shown to significantly influence the disease outcome, regardless of age and comorbidities. Conclusion Our study provides a comprehensive overview of the hospitalized Brazilian COVID-19 patients profile and the mortality risk factors. The analysis also evidenced that the disease outcome is influenced by multiple factors, as unequally affects different segments of population.

The intersection between COVID-19 and obesity in the context of an emerging country

“…After the initial selection of the one hundred and twenty-five articles, our advanced research identified nine studies referencing "obesity, COVID-19, and Brazilian population". Of these, de Souza et al, 2021, on the analysis of mortality risk factors for hospitalized COVID-19 patients using the major Brazilian database, found that the rate of hospitalized COVID-19 patients with obesity was 11.76%, of whom 43.40% died [8]. Also, they showed a significant hazard ratio for BMI 40 kg/m 2 associated with higher mortality risk [8].…”

“…Of these, de Souza et al, 2021, on the analysis of mortality risk factors for hospitalized COVID-19 patients using the major Brazilian database, found that the rate of hospitalized COVID-19 patients with obesity was 11.76%, of whom 43.40% died [8]. Also, they showed a significant hazard ratio for BMI 40 kg/m 2 associated with higher mortality risk [8]. Nunes et al, 2020 measure the occurrence of multimorbidity to estimate the number of individuals in the Brazilian population 50 years or older at risk for severe COVID-19 [4].…”

Asthma in Adult Patients with COVID-19. Prevalence and Risk of Severe Disease

“…Multivariable modeling was used in a subset of 24 studies of asthma and COVID-19 mortality (13,17,24,29,46,58,74,76,78,82,90,98,105,118,119,124,127,143,146,152,(155)(156)(157)(158), with adjustment for such factors as age, sex, ethnicity/race, education, and various comorbidities. These studies showed meta-odds ratio = 0.82 (95% CI, 0.79-0.85; P , 0.001), albeit with significant heterogeneity (I 2 = 59.1%; 95% CI, 29.7-72.9) (Table E2).…”

Pyridostigmine in the treatment of adults with severe SARS-CoV-2 infection (PISCO): a randomised, double-blinded, phase 2/3, placebo-controlled trial

“…Early reports estimated mortality rates as high as 49% for hospitalized patients with severe COVID-19 18 . Although the in-hospital mortality rate has been declining throughout the pandemic, recent studies still show rates ranging from 20 to over 40% 19–21 . The risk of death still exceeded 20% in the dexamethasone and tocilizumab arms of the RECOVERY trial, being the only two treatments so far that have shown a decrease in mortality 6, 21 .…”