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Sardinha DM, Ferreira ALDS, Guimarães RJDPSE, Lima KVB, Lima LNGC. Clinical Characteristics and Outcomes among Vaccinated and Unvaccinated Patients with Cardiovascular Disease Who Were Hospitalized for COVID-19 in Brazil: Retrospective Cohort. Vaccines (Basel) 2023; 11:vaccines11040861. [PMID: 37112773 PMCID: PMC10146801 DOI: 10.3390/vaccines11040861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION COVID-19 in Brazil has already caused, and it still causes, several impacts on health, economy, and education. The risk factors for death involved those with cardiovascular diseases (CVD), which were prioritized for the vaccination of COVID-19. OBJECTIVE To investigate the clinical characteristics and outcomes between vaccinated and unvaccinated patients with cardiovascular diseases hospitalized for COVID-19 in Brazil in the year 2022. METHODS A retrospective cohort was analyzed from the year 2022, with cases being hospitalized by COVID-19 being drawn from SIVEP-GRIPE surveillance. We compared clinical characteristics, comorbidities, and outcomes between CVD carriers and non-carriers, and we also compared vaccinated with two doses vs. those that are unvaccinated in CVD carriers. We performed chi-square, odds ratio, logistic regression, and survival analysis. RESULTS We included, in the cohort, 112,459 hospital inpatients. An amount of 71,661 (63.72%) of the hospitalized patients had CVD. Regarding deaths, 37,888 (33.69%) died. Regarding vaccination against COVID-19, 20,855 (18.54%) people were not vaccinated with any dose among those with CVD. Death p- < 0.001 (OR 1.307-CI 1.235-1.383) and fever p- < 0.001 (OR 1.156-CI 1.098-1.218) were associated with the unvaccinated CVD carriers, and diarrhea p-0.015 (OR 1.116-CI 1.022-1.218), dyspnea p-0.022 (OR 1.074-CI 1.011-1.142), and respiratory distress p-0.021 (OR 1.070-CI 1.011-1.134) were also recorded. Those patients who possessed predictors of death, including invasive ventilation (p- < 0.001 (OR 8.816-CI 8.313-9.350)), were admitted to the ICU p- < 0.001 (OR 1.754-CI 1.684-1.827), and some had respiratory distress p- < 0.001 (OR 1.367-CI 1.312-1.423), dyspnea p < 0.001 (OR 1.341-CI 1.284-1.400), O2 saturation < 95% p- < 0. 001 (OR 1.307-CI 1.254-1.363), they were unvaccinated against COVID-19 p- < 0.001 (OR 1.258-CI 1.200-1.319), they were of male sex p- < 0.001 (OR 1.179-CI 1.138-1.221), they had diarrhea p-0.018 (OR 1.081-CI 1.013-1.154), and they may have been old p < 0.001 (OR 1.034-CI 1.033-1.035). Survival was shorter for the unvaccinated p-0.003, and p- <0.001. CONCLUSIONS We highlight the predictors of death for those unvaccinated against COVID-19 in this research, and we evidenced the benefits of the COVID-19 vaccine in reducing deaths in hospitalized CVD patients.
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Affiliation(s)
- Daniele Melo Sardinha
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua 67030-000, Pará, Brazil
- Laboratório de Geoprocessamento do Instituto Evandro Chagas (LABGEO/IEC), Ananindeua 67030-000, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Ana Lúcia da Silva Ferreira
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Ricardo José de Paula Souza E Guimarães
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua 67030-000, Pará, Brazil
- Laboratório de Geoprocessamento do Instituto Evandro Chagas (LABGEO/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Karla Valéria Batista Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
| | - Luana Nepomuceno Gondim Costa Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil
- Seção de Bacteriologia e Micologia, Laboratório de Biologia Molecular, Instituto Evandro Chagas (SABMI/LABMOL/IEC), Ananindeua 67030-000, Pará, Brazil
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Costa GF, Garcez JCD, Marcos W, Ferreira ALDS, Andrade JAA, Rodrigues YC, Lima LNGC, Conceição EC, Lima KVB. Factors Associated with Tuberculosis Outcome in a Hyperendemic City in the North of Brazil. Healthcare (Basel) 2023; 11:healthcare11040508. [PMID: 36833042 PMCID: PMC9957009 DOI: 10.3390/healthcare11040508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 02/11/2023] Open
Abstract
Ananindeua city, State of Pará, North of Brazil, is a hyperendemic area for tuberculosis (TB), with a cure rate below the recommendation by the Brazilian Ministry of Health. We aimed to describe: (I) the TB incidence coefficient of Ananindeua municipality comparatively against Brazilian data; (II) TB treatment outcomes; (III) to compare the socioeconomic and epidemiological characteristics of abandonment versus cure outcome; and (IV) to evaluate the risk factors associated with TB treatment abandonment in Ananindeua city, from 2017 to 2021. This is a retrospective, descriptive, and cross-sectional epidemiological study which used secondary TB entries. Data were analyzed by linear regression, descriptive statistics, and associations were made using the Chi-square test and G-test, followed by univariate and multivariate logistic regression analyses. Cure rates ranged from 28.7% to 70.1%, abandonment between 7.3% and 11.8%, deaths from the disease ranged from 0% to 1.6%, and drug-resistant tuberculosis (TB-DR) rates had frequencies from 0% to 0.9%. Patient transfer rates to other municipalities were between 4.9% and 12.5%. The multivariate analysis showed that alcohol is almost 2 times more likely to lead an individual to abandon treatment and use of illicit drugs was almost 3 times more likely. Individuals between 20 and 59 years of age were also more likely to abandon treatment almost twice as often. Finally, data obtained in the present report is of great relevance to strengthen epidemiological surveillance and minimize possible discrepancies between the information systems and the reality of public health in high endemicity areas.
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Affiliation(s)
- Gabriel Fazzi Costa
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Correspondence: (G.F.C.); (K.V.B.L.); Tel.: +55-91-3214-2116 (K.V.B.L.)
| | - Juliana Conceição Dias Garcez
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | - Weber Marcos
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | - Ana Lúcia da Silva Ferreira
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
| | | | - Yan Corrêa Rodrigues
- Program in Epidemiology and Health Surveillance (PPGEVS), Evandro Chagas Institute (IEC), Ananindeua 67030-000, PA, Brazil
| | - Luana Nepomuceno Gondim Costa Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health of Brazil, Ananindeua 67030-000, PA, Brazil
| | - Emilyn Costa Conceição
- Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Karla Valéria Batista Lima
- Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Belém 66087-662, PA, Brazil
- Bacteriology and Mycology Section, Evandro Chagas Institute (SABMI/IEC), Ministry of Health of Brazil, Ananindeua 67030-000, PA, Brazil
- Correspondence: (G.F.C.); (K.V.B.L.); Tel.: +55-91-3214-2116 (K.V.B.L.)
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Sardinha DM, do Socorro Pompeu de Loiola R, Ferreira ALDS, de Sá CAF, Rodrigues YC, Lima KVB, E Guimarães RJDPS, Lima LNGC. Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon. Sci Rep 2021; 11:20569. [PMID: 34663823 PMCID: PMC8523658 DOI: 10.1038/s41598-021-00009-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
The Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.
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Affiliation(s)
- Daniele Melo Sardinha
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.
| | - Rosane do Socorro Pompeu de Loiola
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Universidade Federal do Pará (PPGBAIP/UFPA), Belém, Pará, Brazil
| | - Ana Lúcia da Silva Ferreira
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | - Carmem Aliandra Freire de Sá
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil
| | - Yan Corrêa Rodrigues
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | - Karla Valéria Batista Lima
- Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
| | | | - Luana Nepomuceno Gondim Costa Lima
- Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua, Pará, Brazil.,Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará, Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Ananindeua, Pará, Brazil
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Sardinha DM, Lima KVB, Ueno TMRL, Rodrigues YC, Garcez JCD, Santos ALSD, Ferreira ALDS, Guimarães RJDPSE, Lima LNGC. Occurrence of Cardiovascular Complications Associated with SARS-CoV-2 Infection: A Systematic Review. JPRI 2021. [DOI: 10.9734/jpri/2021/v33i1431270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiovascular Diseases represent the main cause of death in the world, and are associated with risk factors that cause serious complications in cases of infections, such as those of the respiratory tract. In March 2020 the World Health Organization declared a pandemic for SARS-CoV-2, a new coronavirus causing severe pneumonia, which emerged in December 2019 in Wuhan, China. The objective is to investigate the occurrence of cardiovascular complications associated with SARS-CoV-2 infection. It is a systematic review, quantitative, in the databases, PubMed and Science direct, including primary studies with hospitalized patients confirmed for COVID-19 and who presented cardiovascular complications, the form used tools for evaluation of quality and evidence, following the PRISMA recommendations. Results: 12 studies were included. The occurrence of cardiovascular complications was: 27.35% of the sample of 3,316 patients. Types: Acute cardiac injury 17.09%; Thromboembolism 4.73%; Heart failure 3.43%; Arrhythmias 1.77%; stroke 0.33%. Mean age 61 years. Conclusions: This study showed that there are several cardiovascular complications associated with SARS-CoV-2, that the main one is acute cardiac injury, which causes several instabilities in the cardiopulmonary system, and that it is associated with mortality.
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