Cohort study of hospitalized patients with COVID-19 at Brazilian tertiary-care hospital: Occurrence of adverse events and mortality

• Published in: The Brazilian journal of infectious diseases Vol. 27; no. 4; p. 102791
• Main Authors: Luz, Maitê Vasconcelos, Silva, Julian Furtado, Ceccato, Hugo Dugolin, de Souza Júnior, Paulo José, Villar, Pedro Maximink, Mendes, Paulo Roberto Araújo, Resende, Mariângela Ribeiro, Pereira, Mônica Corso, Oliveira Conterno, Lucieni
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Elsevier España, S.L.U 01.07.2023; Contexto; Elsevier; Brazilian Society of Infectious Diseases
• Subjects: Adverse events; Bacterial pneumonia; Brazil; Comparative analysis; Complications and side effects; Control; COVID-19; Epidemics; Epidemiology; Evaluation; Hospital patients; INFECTIOUS DISEASES; Medical research; Medicine, Experimental; Mortality; Nosocomial infection; Original; Pneumonia; Risk factors; Brazil; COVID-19; Nosocomial infection; Adverse events; Mortality; Risk factors
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1016/j.bjid.2023.102791

Patients hospitalized with COVID-19 are often submitted to invasive procedures and they are at risk for hospital-associated adverse events. To evaluate the epidemiological and clinical aspects of patients hospitalized with COVID-19; the occurrence of adverse events and the risk factors for mortality. Cohort study that included adult patients hospitalized with a diagnosis of SARSCoV-2 infection, at the tertiary University Hospital of UNICAMP from March 2020 to March 2021. Patients were identified through the hospital epidemiological surveillance system and followed until discharge or death. Descriptive, comparative, and logistic regression analysis was performed. 650 adult patients were included. The main adverse events identified were nosocomial infections (31.5%), renal failure (33.8%), thromboembolic and vascular events (12.6%). Mortality was higher among those with bloodstream infections (30.2% vs. 8.6%; p < 0.0001), ventilator-associated pneumonia (VAP, 52.5% vs. 12.3%; p < 0.0001), catheter associated urinary infection (27.3% vs. 7.2%; p < 0.0001); thromboembolic and vascular events (23.0% vs. 9.9%; p < 0.0001) and renal failure (81.3% vs. 20.9%; p < 0.0001). Klebsiella pneumoniae (15.6%), Pseudomonas aeruginosa (14.4%), Enterococcus faecalis (8.6%) were the most isolated bacteria. Logistic regression analysis identified age, (RR = 1.03; 95% CI 1.02 to 1.05); ICU admission (RR = 3.06; 95% CI 1.59 to 5.87), vasoactive drug use (RR = 3.1; 95% CI 1.79 to 4.82); renal failure (RR = 7.76; 95% CI 4.54 to 13.26); and VAP (RR = 2.2; 95% CI 1.23 to 3.96), independently associated with mortality. adverse events have an important impact on the evolution of patients with COVID-19, reinforcing the need for optimized prevention and control measures as an essential part of care for these patients.