0031/2025 - Fatores associados à ocorrência de Síndrome Respiratória Aguda Grave (SRAG) entre casos de COVID-19 Factores asociados con la ocurrencia de Síndrome Respiratorio Agudo Grave (SRAG) entre casos de COVID-19
Este estudo de coorte retrospectivo investigou fatores associados à Síndrome Respiratória Aguda Grave (SRAG) ou óbito entre casos confirmados de COVID-19 atendidos em uma unidade de Atenção Primária à Saúde no Rio de Janeiro, entre agosto/2020 e janeiro/2022. A ocorrência de SRAG ou óbito foi identificada, respectivamente, nos Sistemas de Informação da Vigilância Epidemiológica da Gripe e de Informação sobre Mortalidade. Características individuais, sintomas e variante viral predominante foram as variáveis explicativas testadas em modelos de regressão logística. Dos 1708 episódios de COVID-19, 7 (4,2%) resultaram em SRAG, dos quais 17 (1,0%) foram a óbito. Entre os fatores de risco para SRAG, destacaram-se obesidade (OR: 19,71; IC95%: 7,47-52,77), gravidez (OR: 16,8; IC95%: 1,8-111,2), doença cardíaca crônica (OR: 6,6; IC95%: 1,1-28,4), diabetes (OR: 2,8; IC95%: 1,2-5,9), dispneia (OR: 7,0; IC95%: 3,6-13,6), febre (OR: 2,4; IC95%: 1,3-4,4) e adoecer no período de predomínio da variante Gamma. Não houve casos de agravamento durante o predomínio da variante Ômicron. Conclui-se que o risco de agravamento da COVID-19 depende de características individuais dos pacientes, bem como das variantes virais circulantes, enfatizando assim o papel essencial da vigilância contínua para identificar mudanças no cenário epidemiológico e orientar estratégias de prevenção e cuidado.
Palavras-chave:
COVID-19, Prognóstico, Atenção Primária à Saúde
Abstract:
This retrospective cohort study investigated factors associated with Severe Acute Respiratory Syndrome (SARS) or death among confirmed COVID-19 cases treated at a Primary Health Care unit in Rio de Janeiro,August 2020 to January 2022. The occurrence of SARS or death was identified in the Systems of Information of Epidemiological Surveillance of Influenza and Mortality Information, respectively. Individual characteristics, symptoms, and predominant viral variant were the explanatory variables tested in logistic regression models. Out of 1,708 COVID-19 episodes, 72 (4.2%) resulted in SARS, of which 17 (1.0%) were fatal. Among the risk factors for SARS, obesity (OR: 19.7; 95% CI: 7.5-52.8), pregnancy (OR: 16.8; 95% CI: 1.8-111.2), chronic heart disease (OR: 6.6; 95% CI: 1.1-28.4), diabetes (OR: 2.8; 95% CI: 1.3-5.9), dyspnea (OR: 7.0; 95% CI: 3.6-13.6), fever (OR: 2.4; 95% CI: 1.3-4.4), and illness during the predominance of the Gamma variant were highlighted. There were no cases of worsening during the predominance of the Omicron variant. It is concluded that the risk of COVID-19 worsening depends on individual patient characteristics as well as the circulating viral variants, emphasizing the essential role of continuous surveillance in identifying changes in the epidemiological landscape and guiding prevention and care strategies.
Factores asociados con la ocurrencia de Síndrome Respiratorio Agudo Grave (SRAG) entre casos de COVID-19
Resumo (abstract):
This retrospective cohort study investigated factors associated with Severe Acute Respiratory Syndrome (SARS) or death among confirmed COVID-19 cases treated at a Primary Health Care unit in Rio de Janeiro,August 2020 to January 2022. The occurrence of SARS or death was identified in the Systems of Information of Epidemiological Surveillance of Influenza and Mortality Information, respectively. Individual characteristics, symptoms, and predominant viral variant were the explanatory variables tested in logistic regression models. Out of 1,708 COVID-19 episodes, 72 (4.2%) resulted in SARS, of which 17 (1.0%) were fatal. Among the risk factors for SARS, obesity (OR: 19.7; 95% CI: 7.5-52.8), pregnancy (OR: 16.8; 95% CI: 1.8-111.2), chronic heart disease (OR: 6.6; 95% CI: 1.1-28.4), diabetes (OR: 2.8; 95% CI: 1.3-5.9), dyspnea (OR: 7.0; 95% CI: 3.6-13.6), fever (OR: 2.4; 95% CI: 1.3-4.4), and illness during the predominance of the Gamma variant were highlighted. There were no cases of worsening during the predominance of the Omicron variant. It is concluded that the risk of COVID-19 worsening depends on individual patient characteristics as well as the circulating viral variants, emphasizing the essential role of continuous surveillance in identifying changes in the epidemiological landscape and guiding prevention and care strategies.
