Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil

Colnago, Marilaine; Benvenuto, Giovana A.; Casaca, Wallace; Negri, Rogério Galante; Fernandes, Eder Gatti; Cuminato, José Alberto

doi:10.3390/bioengineering9100584

Cited by 17 publications

(20 citation statements)

References 58 publications

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“…Furthermore, the older cohort of 60-79 years has a higher burden of NCDs compared to their younger counterparts in Nepal. Global data showed that the highest death rate was noted in those with cardiovascular diseases, followed by diabetes, chronic respiratory diseases, hypertension, and cancer [30][31][32]. Our study showed that 4 in 10 deceased had hypertension and almost 1 in 3 had type 2 diabetes, compared to the national prevalence of hypertension of 32% (95% CI: 23%-40%) [33] and type 2 diabetes of 8.5% (95% CI: 6.9%-10.4%) [34] among the adult population.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of COVID‐19 mortality in Nepal: An analysis of the National Health Emergency Operation Center data

Adhikari,

Ranabhat,

Bhattarai

et al. 2023

Public Health Challenges

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IntroductionCOVID‐19 had caused nearly 12,000 deaths in Nepal by March 2023. In this study, we compare COVID‐19‐associated mortality in the first (September 15 to November 30, 2020) and second (April 15 to June 30, 2021) waves of the pandemic in Nepal and investigate the associated epidemiological factors.MethodsWe disaggregated the COVID‐19‐related deaths between the first and second waves of the pandemic using the national COVID‐19 database and evaluated the association of independent variables with the deaths in the first versus second waves.ResultsOut of 8133 deaths, 25% died in the first wave and 75% in the second. Overall, 33.5% of the deceased were female, and 52% of the deaths were in those 60 years or older. A vast majority (92%) of deaths occurred in hospitals. Geographically, the middle “Hill” region (58.3%) witnessed the most significant number of deaths. About two thirds (64%) had at least one comorbid condition. Multivariable logistic regression showed a difference in the reported deaths by province (state) and geography (ecological region) between the first and second waves. Those in the age groups “19–39 years” and “40–59 years” were more likely to die in the second wave than in the first wave compared to the younger age group.ConclusionsOverall, deaths were concentrated among older age groups, males, in the Hill regions, in the western provinces, and those with comorbidities. Therefore, the country must focus on these areas to ensure an efficient and effective pandemic response in the future.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of COVID‐19 mortality in Nepal: An analysis of the National Health Emergency Operation Center data

Adhikari,

Ranabhat,

Bhattarai

et al. 2023

Public Health Challenges

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“…Prior to antibody staining the cells were stained with the fixable viability dye, Zombie (Biolegend, USA) in PBS. The cells were stained with antibodies against CD3, CD4, CD8, IFN-γ, TNF-α, IL-2 and IL1-β (Biolegend, USA), Approximately 1×10 5 cells were acquired using a LSRII Flow Cytometer (Becton Dickinson, USA) and the data analysed using FloJo software (version 10.1; Treestar, USA). Dead cells were excluded from the scatter plots prior to analysis, and negative gates were set using fluorescence minus one (FMO) controls.…”

Section: Online Materials and Methodsmentioning

confidence: 99%

“…Case fatality risk (CFR) in hospitalised patients, and particularly in mechanically ventilated patients, during the Beta and Delta waves was particularly high (~50%-70%; 1 ). Even with the Omicron-related variants, CFR remains significant in the elderly and immunocompromised persons, and in several countries including the UK, Italy, France, Brazil, and China where there is an unfolding epidemic of severe COVID-19 disease [2][3][4][5][6][7][8][9][10] .Better therapeutic interventions are needed. However, despite considerable research, the pathogenesis of severe COVID-19, relative to viral kinetics, remains incompletely understood.…”

mentioning

confidence: 99%

SARS-CoV-2 viral replication persists in the human lung for several weeks after symptom onset

Tomasicchio

Jaumdally

Pooran

et al. 2023

Preprint

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The immunopathogenesis of severe COVID-19 is incompletely understood. In contradistinction to the upper respiratory tract where replicating (culturable) SARS-CoV-2 is recoverable approximately ~ 4 to 8 days after symptom onset, there is paucity of data about the frequency or duration of replicating virus in the lower respiratory tract (the human lung). We undertook lung tissue sampling (needle biopsy), within ~2 hours of death, in 42 mechanically ventilated decedents during the Beta and Delta waves. Lung biopsy cores underwent viral culture, histopathological analysis, electron microscopy, transcriptomic profiling, immunohistochemistry and cell-based flow cytometry of deconstructed tissue. 38% (16/42) of patients had culturable virus in the lung (persisting for up to 4 weeks after symptom onset). This, hitherto, undescribed bio-phenotype of lung-specific persisting viral replication was associated with an enhanced pulmonary pro-inflammatory response and variant-specific increased rates of bacterial bronchopneumonia and accelerated death. These findings question existing paradigms and suggest that in a subset of patients, concurrent, rather than sequential active viral replication continues to drive a heightened pro-inflammatory response. Our findings have potential implications for the design of therapeutic interventional strategies and clinical management of severe COVID-19 disease.

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“…In summary, the clinical characteristics of COVID‐19 caused by Omicron might be different from those of the original strain. Currently, studies have primarily focused on the clinical characteristics and risk factors for severe illness caused by Omicron subvariants BA.1 and BA.2 15–17 . And no studies have comprehensively investigated the clinical characteristics and factors for critical illness caused by Omicron subvariant BF.7.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and factors for serious outcomes among outpatients infected with the Omicron subvariant BF.7

Yang,

Wang,

Zhang

et al. 2023

Journal of Medical Virology

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To evaluate clinical characteristics and identify risk factors associated with severe outcomes in outpatients infected with the Omicron subvariant BF.7, data were collected from outpatients diagnosed with Corona Virus Disease 2019 from December 19, 2022 to January 5, 2023. Clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with serious outcomes. Variables with a p < 0.10 in the univariate analysis were included in the multivariate model. Our study analyzed 770 patients, of whom 380 (49.4%) were male, with a median age of 59. The most common symptoms reported were cough (71.2%), fever (64.7%), and sore throat (37.7%). Fever lasted an average of 5.93 ± 3.37 days for the general population and 10.64 ± 7.12 days for impaired‐immunity patients. Most cases were mild (68.7%), followed by moderate (27.1%). Severe cases accounted for 2.2%, with 0.5% critically ill. Serious outcomes occurred in 4.2% of cases, with 11 deaths during follow‐up. Underlying‐diseases patients had a higher rate of serious outcomes. Factors associated with serious outcomes included receiving a three‐dose vaccination (odds ratio [OR] = 0.324, 95% confidence interval [CI]: 0.113–0.932, p = 0.037), male gender (OR = 2.890, 95% CI: 1.107–7.548, p = 0.030), age (OR = 1.060, 95% CI: 1.024–1.097, p = 0.001), and chest tightness or dyspnea at the time of visit (OR = 4.861, 95% CI: 2.054–11.507, p < 0.001). Our study found that cough, fever, and sore throat were the most common symptoms reported by patients. Receiving a three‐dose vaccination was protective, while male gender, age, and chest tightness or dyspnea were identified as risk factors for serious outcomes.

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Risk Factors Associated with Mortality in Hospitalized Patients with COVID-19 during the Omicron Wave in Brazil

Cited by 17 publications

References 58 publications

Epidemiology of COVID‐19 mortality in Nepal: An analysis of the National Health Emergency Operation Center data

Epidemiology of COVID‐19 mortality in Nepal: An analysis of the National Health Emergency Operation Center data

SARS-CoV-2 viral replication persists in the human lung for several weeks after symptom onset

Clinical characteristics and factors for serious outcomes among outpatients infected with the Omicron subvariant BF.7

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