Análise dos desfechos clínicos e de marcadores evolutivos em pacientes internados com COVID-19 em um hospital do sistema único de saúde

Abstract

Objectives: Analyze the evolution presented by patients hospitalized with the moderate or severe form of COVID-19, know the sociodemographic profile, the comorbidities presented by this sample and verify the complete data of the records found in the medical records. Materials and Methods: A retrospective, analytical and descriptive study was carried out on a sample consisting of 934 patients admitted in the period 2020/21, at the Hospital de Clínicas of the Federal University of UberlândiaHCUFU. Patients over 18 years of age with a confirmed clinical and laboratory diagnosis of COVID-19 at the time of admission were included, whose medical records could be accessed. The various variables were statistically analyzed using the X2 Test and the Odds Ratio calculation, comparing patients who were discharged from hospital and those who died. Results: In the sample analyzed, 137 patients died (14.66%). When comparing the groups (survivors -hypertensives, diuretics, oral hypoglycemic drugs, hormonal therapy, corticosteroids, drop in hemoglobin saturation, cough, fever, fatigue, anorexia, nausea, anosmia, dysgeusia, vomiting and diagnosis of pneumonia. The predictive variables for lower hospital mortality were: being white, having a diagnosis of systemic arterial hypertension, using oral hypoglycemic medication and having a cough and fever. The greater chance of death was related to older age, being male, having reduced hemoglobin saturation, reporting myalgia and having a diagnosis of pneumonia. Flaws were found in the medical records characterized by the lack of records related to the patients' past history, the treatment instituted and the complications presented. The statistical test (X2) showed a difference in the comparison between the two groups regarding length of stay, age, male sex, diagnosis of systemic arterial hypertension, obesity, autoimmune disease, kidney disease, stroke, chronic obstructive pulmonary disease, use of antihypertensives, diuretics, oral hypoglycemic agents, hormonal therapy, corticosteroids, drop in hemoglobin saturation, cough, fever, fatigue, anorexia, nausea, anosmia, dysgeusia, vomiting and diagnosis of pneumonia. Conclusions: The study revealed the clinical course of patients with COVID-19 in serious condition, from admission to the tragic outcome of death. This information can be crucial in formulating public health strategies for targeted screening and effective control of modifiable risk factors, such as smoking, hypertension, and diabetes, with the aim of reducing both the morbidity and mortality associated with the disease.