Mortality, hospitalizations, and persistence of symptoms in the outpatient setting of the first COVID-19 wave in Brazil: results of SARS-Brazil cohort study.
Henrique Andrade Rodrigues Fonseca, Adriano Jose Pereira, Ricardo Kenji Nawa, Viviane Aparecida Rodrigues Sant'Anna, Tatiana Ferreira de Almeida, Hélio Penna Guimarães, Alexandre Pereira Tognon, Lucas Miranda Marques, Lucas Santana Coelho da Silva, Rafaela de Souza Bittencourt, Camila Pachêco Gomes, Priscila de Aquino Martins, Aryadne Lyrio de Oliveira, Eveline Pipolo Milan, Frederico Toledo Campos Dall'Orto, Conrado Roberto Hoffman Filho, Guacyra Almeida, Fábio Barlem Hohmann, Diogo Duarte Fagundes Moia, Luciana Pereira Almeida Piano, Felipe Pinheiro Machado, Ronaldo Vicente Pereira Soares, Lucas Petri Damiani, Silvia Regina Lamas Assis, Edson Amaro Junior, Luiz Vicente Rizzo, Otávio Berwanger
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Abstract
Objective: To evaluate deaths, hospitalizations, and persistence of symptoms in patients with COVID-19 after infection in an outpatient setting during the first COVID-19 wave in Brazil.
Methods: This prospective cohort was between April 2020 and February 2021. Hospitalized or non-hospitalized COVID-19 patients until five days after symptom onset were included. The outcomes measured were incidence of death, hospitalization, and persistence of more than two symptoms 60 days after discharge.
Results: Out of 1,198 patients enrolled in the study, 66.7% were hospitalized. A total of 289 patients died (1 [0.3%] non-hospitalized and 288 [36%] hospitalized). At 60 days, patients non-hospitalized during admission had more persistent symptoms (16.2%) compared to hospitalized (37.1%). The COVID-19 severity variables associated with the persistence of two or more symptoms were increased age (OR= 1.03; p=0.015), respiratory rate at hospital admission (OR= 1.11; p=0.005), length of hospital stay of more than 60 days (OR= 12.24; p=0.026), and need for intensive care unit admission (OR= 2.04; p=0.038).
Conclusion: COVID-19 survivors who were older, tachypneic at admission, had a hospital length of stay >60 days, and were admitted to the intensive care unit had more persistent symptoms than patients who did not require hospitalization in the early COVID-19 waves.ClinicalTrials.gov Identifier: NCT04479488.
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