COVID in women in Brazil: length of stay and outcomes of first hospitalizations

Keywords: Hospitalization; Length of Stay; Coronavirus Infections; Intensive Care Units; Women.

Abstract

Objective: to analyze the length of hospital stay and outcomes of the first hospitalizations due to COVID-19 of women at the beginning of the pandemic. Methods: ecological study with data on COVID-19 hospitalizations of women. Data classification was done by states, regions, age, length of hospital stay, main and secondary diagnosis (underlying diseases), and outcome. Kruskal-Wallis, Mann-Whitney, and chi-square tests were used for the analysis. Results: the Southeast region had the highest number of hospitalizations (0.6%). Of the total number of hospitalizations, 14.6% required an intensive care unit. The length of hospital stay of women over 50 years was significant for Brazil (p<0.001). There was an association between length of hospital stay and levels 2 and 3 of comorbidity. Deaths in women over 50 years old were significant in Brazil, Northeast, and Southeast (p<0.001). Conclusion: women over 50 years old with comorbidities are associated with longer hospital stays and deaths.


References

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395(10226):809-15. doi: http://doi.org/10.1016/S0140-6736(20)30360-3

World Health Organization. Coronavirus disease 2019 (COVID-19) situation report – 63 [Internet]. 2020 [cited Jan. 28, 2021]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382(8):727-33. doi: https://www.nejm.org/doi/full/10.1056/nejmoa2001017

Quian GQ, Yang NB, Ding F, Ma AHY, Wang ZY, Shen YF, et al. Epidemiologic and clinical characteristics of 91 hospitalized patients with COVID-19 in Zhejiang, China: a retrospective, multi-centre case series. Int J Med. 2020; 113(7):474-81. doi: https://doi.org/10.1093/qjmed/hcaa089

Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Boletim epidemiológico especial: doença pelo coronavírus covid-2019 [Internet]. 2020 [cited Jan. 28, 2021]. Available from: https://portalarquivos2.saude.gov.br/images/pdf/2020/September/23/Boletim-epidemiologico-COVID-32-final-23.09_18h30.pdf

Singh AK, Singh A, Shaikh A, Singh R, Misra A. Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: a systematic search and a narrative review with a special reference to India and other developing countries. Diabetes Metabol Syn. 2020; 14(3):241-6. doi: https://doi.org/10.1016/j.dsx.2020.03.011

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-9. doi: https://doi.org/10.1001/jama.2020.1585

Blasco ML, Buesa J, Colomina J, Forner MJ, Galindo MJ, Navarro J, et al. Co-detection of respiratory pathogens in patients hospitalized with coronavírus viral disease-2019 pneumonia. J Med Virol. 2020; 92(10):1799-801. doi: https://doi.org/10.1002/jmv.25922

Grasseli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 aAdmitted to ICUs of the Lombardy Region, Italy. JAMA. 2020; 323(16):1574-81. doi: https://doi.org/10.1001/jama.2020.5394

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020; 323(20):2052-9. doi: https://doi.org/10.1001/jama.2020.6775

Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalizations rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 – COVID-NET, 14 states, march 1-30, 2020. Morbid Mortal W. 2020; 69(15):458-64. doi: http://dx.doi.org/10.15585/mmwr.mm6915e3

Ministério da Saúde (BR). Protocolo de manejo clínico da Covid-19 na atenção especializada [Internet]. 2020 [cited Jan 27, 2021]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/manejo_clinico_covid-19_atencao_especializada.pdf

Sistema de Informação Hospitalar Descentralizado. Transferência/Download de arquivos [Internet]. 2020 [cited Jan 16, 2021]. Available from: http://www2.datasus.gov.br/DATASUS/index.php?area=0901

Rache B, Rocha R, Nunes L, Spinola P, Malik AM, Massuda A. Necessidades de Infraestrutura do SUS em preparo à COVID-19: leitos de UTI, respiradores e ocupação hospitalar [Internet]. 2020 [cited Jan 27, 2021]. Available from: https://ieps.org.br/wp-content/uploads/2020/04/IEPS-NT3.pdf

Abdulrahim S, Bousmah M. Regional Inequalities in Maternal and Neonatal Health Services in Iraq and Syria from 2000 to 2011. Int J Health Serv. 2019; 49(3):623-41. doi: http://doi.org/10.1177/0020731419851659

Candido DS, Watts A, Abade L, Kraemer MUG, Pybus OG, Croda J, et al. Routes for COVID-19 importation in Brazil. J Travel Med. 2020; 27(3):taaa042. doi: https://doi.org/10.1093/jtm/taaa042

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054–62. doi: https://doi.org/10.1016/S0140-6736(20)30566-3

Thai PQ, Toan DTT, Son DT, Van HTH, Minh LN, Hung LX, et al. Factors associated with the duration of hospitalisation among COVID-19 patients in Vietnam: a survival analysis. Epidemiol Infect. 2020; 148:e114. doi: https://doi.org/10.1017/S0950268820001259

Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, et al. Severe obesity is associated with higher in-hospital mortality in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020; 108:154262. doi: https://doi.org/10.1016/j.metabol.2020.154262

Blitz MJ, Rochelson B, Minkoff H, Meirowitz N, Prasannan L, London V, et al. Maternal Mortality Among Women with COVID-19 Admitted to the Intensive Care Unit. Am J Obstet Gynecol. 2020; 223(4):595-599.e5. doi: https://doi.org/10.1016/j.ajog.2020.06.020

Published
2021-04-19
Section
Research Article