0231/2020 - Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro Fatores de risco associados ao atraso no diagnóstico e mortalidade em pacientes com COVID-19 na cidade do Rio de Janeiro
Investigamos os preditores de atraso no diagnóstico e mortalidade de pacientes com COVID-19 no Rio de Janeiro, Brasil. Uma coorte de 3.656 pacientes foi avaliada (fevereiro-abril de 2020) e as características sociodemográficas dos pacientes, o bairro e o índice de desenvolvimento social (IDS) foram usados como fatores determinantes dos atrasos no diagnóstico e da mortalidade. Foram realizadas análises de sobrevivência de Kaplan-Meier, modelos de regressão Cox dependentes do tempo e análises de regressão logística multivariada. O tempo mediano desde o início dos sintomas até o diagnóstico foi de oito dias (intervalo interquartil [IQR] 7,23-8,99dias). Metade dos pacientes se recuperou no período avaliado e 8,3% faleceram. As taxas de mortalidade foram maiores nos homens. Atrasos no diagnóstico foram associados ao sexo masculino (p = 0,015) e pacientes que moravam em áreas com baixo IDS (p
Palavras-chave:
COVID-19; análise multivariada; mortalidade
Abstract:
We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients’ sociodemographic characteristics,and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median timesymptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years (p = 0.006), 80-89 years (p < 0.001), and 90-99 years (p = 0.001). Delays to diagnosis greater than eight days were also risk factors for death (p < 0.001). Delays in diagnosis and risk factors for deathCOVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.
Fatores de risco associados ao atraso no diagnóstico e mortalidade em pacientes com COVID-19 na cidade do Rio de Janeiro
Resumo (abstract):
We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients’ sociodemographic characteristics,and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median timesymptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years (p = 0.006), 80-89 years (p < 0.001), and 90-99 years (p = 0.001). Delays to diagnosis greater than eight days were also risk factors for death (p < 0.001). Delays in diagnosis and risk factors for deathCOVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.
Cobre, A.F, Boger, B, Fachi, M.M, Vilhena, R.O, Domingos, E.L, Tonin, F.S, Pontarolo, R.. Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro. Cien Saude Colet [periódico na internet] (2020/ago). [Citado em 23/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/risk-factors-associated-with-delay-in-diagnosis-and-mortality-in-patients-with-covid19-in-the-city-of-rio-de-janeiro/17713?id=17713
