Covid-19: Fatores associados à mortalidade e ao tempo de sobrevida intra-hospitalar em um Hospital Universitário em Belo Horizonte, Minas Gerais, Brasil.

Abstract

Background: The clinical presentation of covid-19 is broad, from asymptomatic infections to severe and critical disease. The present study aimed to investigate risk factors for intrahospital mortality and lower survival in patients admitted with covid-19 to a public university hospital in Belo Horizonte, Minas Gerais, Brazil. Methods: This observational study included patients with 16 years and more who had been hospitalized for covid-19 between May and October 2020, with data collected prospectively based on electronic medical records. A descriptive and time-to-death analysis was performed using the Cox proportional hazards model in univariate regression followed by a multivariate model with Kaplan Meier survival curve representation. Results: Of the 161 patients included, 39 (24.2%) died during hospitalization. Risk factors for intrahospital mortality were age over 70 years (RR=2.78; p<0.001), male sex (RR=2.28; p=0.005), cardiovascular disease (RR=1.8; p=0.044), and abnormal chest X-ray upon admission (RR=3.07; p=0.022). A high RDW upon admission was also a risk factor in patients over 70 years of age (RR=2; p=0.029), and subsequent evolutionary increase was associated with higher mortality in any age group (RR=4.03; p<0.001). Furthermore, in a multivariate analysis using the Cox Model, the risk factor for lower survival are age ≥70 years, HR=4.8, p<0.001; white race, HR=3.2, p=0.018; need for invasive mechanical ventilation, HR=3.8, p=0.001; and chest X-ray suggestive of covid-19, HR=3.5, p=0.044. Conclusion: The data presented here show that age, male sex, radiographic changes, cardiovascular disease and RDW changes are factors linked to higher intrahospital mortality from covid-19. Advanced age and radiological changes also contribute to a shorter intrahospital survival time.