Survival and predictors of deaths of patients hospitalised due to COVID-19 from a retrospective and multicentre cohort study in Brazil

Santos, Marquiony Marques dos; Lucena, Eudes Euler de Souza; Lima, Kênio Costa de; Brito, Andiara Araújo Cunegundes de; Bay, Mônica Baumgardt; Bonfada, Diego

doi:10.1017/s0950268820002034

Cited by 38 publications

(28 citation statements)

References 17 publications

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“…This is much higher than a case fatality rate of 0·16% in children below 5 years of age in a recent large epidemiological study in Southern India [16]. Several other studies in China [26], Brazil [13,27], Uganda [14], and South Africa [15] have reported COVID-19-related deaths among children under 5 years to be rare. A review of data from US, Korea and Europe early in the epidemic estimated the overall case fatality rate among children (0-19 years old) to be low at 0·03 per 100 000 (44/42 846) [28].…”

Section: Discussionmentioning

confidence: 81%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2020

Preprint

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BackgroundData on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.MethodsThis retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used Cox regression to examine factors associated with mortality.FindingsOf 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had at least one comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5-9; 2% (3/133) for 10-19; 2% (8/638) for 20-29; 3% (26/755) for 30-39; 7% (61/819) for 40-49; 17% (155/941) for 50-59; 22% (132/611) for 60-69; and 34% (96/284) for ≥70. Risk of death was associated with higher age; pre-existing hypertension, cardiac disease, chronic kidney disease or liver disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; and shorter time from symptom onset to admission. Patients <50 years with >1 comorbidity had a nearly six-fold higher risk of death than those without (adjusted hazard ratio 5·50, 95% CI 2·72-11·13; 27% vs 3% mortality).InterpretationOverall mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. However, deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

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Section: Discussionmentioning

confidence: 81%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…This is much higher than a case fatality rate of 0.16% in children below 5 years of age in a recent large epidemiological study in Southern India [16] . Several other studies in China [29] , Brazil [13 , 30] , Uganda [14] , and South Africa [15] have reported COVID-19-related deaths among children under 5 years to be rare. A review of data from US, Korea and Europe early in the epidemic estimated the overall case fatality rate among children (0–19 years old) to be low at 0.03 per 100 000 (44/42 846) [31] .…”

Section: Discussionmentioning

confidence: 95%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2021

The Lancet Regional Health - Western Pacific

117

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Background Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020. Methods This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality. Findings Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5–9; 2% (3/133) for 10–19; 2% (8/638) for 20–29; 3% (26/755) for 30–39; 7% (61/819) for 40–49; 17% (155/941) for 50–59; 22% (132/611) for 60–69; and 34% (96/284) for ≥70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28–10.52; 27% vs 3% mortality). Interpretation Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

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“…Subsequently, 44 articles were excluded because of a sample size less than 100, 47 articles were eliminated due to the potential duplicate patients, and two articles were removed because they reported unclear prevalence of asthma in COVID-19 patients (eTable 2). Ultimately, 116 articles (119 studies) 4 , 6 , 7 , 8 , 9 , 10 , 11 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the studies conducted by Yehia et al 7 and Siso-Almirall et al 8 indicated that asthma was not a significant predictive comorbidity for death of COVID-19 patients. However, Almazeedi et al 9 reported that asthma was significantly associated with an increased risk of death in COVID-19 patients, whereas Hernandez-Galdamez et al 10 and Santos et al 11 found that asthma was a protective factor of death.…”

Section: Introductionmentioning

confidence: 99%

Asthma in patients with coronavirus disease 2019

Shi

Xiao

et al. 2021

Annals of Allergy, Asthma & Immunology

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Background It is unclear if there is the influence of asthma on contracting COVID-19, or having worse outcomes from COVID-19 disease. Objective To explore the prevalence of asthma in COVID-19 patients and the relationship between asthma and COVID-19 patients with poor outcomes. Methods The pooled prevalence of asthma in COVID-19 patients and corresponding 95% confidence interval (CI) were estimated. The pooled effect size (ES) was used to evaluate the association between asthma and COVID-19 patients with poor outcomes. Results The pooled prevalence of asthma in COVID-19 patients worldwide was 8.3% (95% CI 7.6-9.0%) based on 116 articles (119 studies) with 403,392 cases. The pooled ES based on unadjusted effect estimates showed that asthma was not associated with the reduced risk of poor outcomes in COVID-19 patients (ES 0.91, 95% CI 0.78-1.06). Similarly, the pooled ES based on unadjusted effect estimates revealed that asthma was not associated with the reduced risk of mortality in COVID19 patients (ES 0.88, 95% CI 0.73-1.05). However, the pooled ES based on adjusted effect estimates indicated that asthma was significantly associated with the reduced risk of mortality in COVID-19 patients (ES 0.80, 95% CI 0.74-0.86). Conclusion The pooled prevalence of asthma in COVID-19 patients was similar to that in the general population, and asthma might be an independent protective factor for the death of COVID-19 patients, which suggests that we should pay high attention to COVID-19 patients with asthma and take locally tailored interventions and treatment. Further well-designed studies with large sample sizes are required to verify our findings.

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Survival and predictors of deaths of patients hospitalised due to COVID-19 from a retrospective and multicentre cohort study in Brazil

Cited by 38 publications

References 17 publications

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study

Asthma in patients with coronavirus disease 2019

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