Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: results from the Brazilian COVID-19 Registry

Marcolino, Milena S.; Ziegelmann, Patricia K.; Souza-Silva, Maira V.R.; do Nascimento, Israel J. Borges; Oliveira, Luana M.; Monteiro, Luanna S.; Sales, Thaís L.S.; Ruschel, Karen B.; Martins, Karina P.M.P.; Etges, Ana Paula B.S.; Molina, Israel; Polanczyk, Carisi A.

Objectives To describe clinical characteristics, laboratory and imaging findings, as well as in-hospital outcomes of COVID-19 patients admitted to Brazilian hospitals. Methods Cohort study of laboratory-confirmed COVID-19 patients hospitalized from March to September 2020 at 25 hospitals. Study data were collected from medical records using Research Electronic Data Capture (REDCap) tools. Multivariate Poisson regression model was used to assess risk factors for in-hospital mortality. Results Of 2054 patients (52.6% male, median age 58 years old), in-hospital mortality was 22.0%, and 47.6% among those treated in the ICU. Hypertension (52.9%), diabetes (29.2%) and obesity (17.2%) were the most prevalent comorbidities. Overall, 32.5% required invasive mechanical ventilation and 12.1% kidney replacement therapy. Septic shock was observed in 15.0%, nosocomial infection in 13.1%, thromboembolism in 4.1% and acute heart failure in 3.6%. Age ≥65 years-old, chronic kidney disease, hypertension, C-reactive protein ≥100 mg/dL, platelet count <100 × 109/L, oxygen saturation <90%, supplementary oxygen requirement and invasive mechanical ventilation at admission were independently associated with a higher risk of in-hospital mortality. The overall use of antimicrobials was 87.9%. Conclusions This study provides characteristics and in-hospital outcomes of consecutively hospitalized patients with confirmed COVID-19 in Brazil. Easily assessed parameters at hospital admission were independently associated with a higher risk of death. The high frequency of antibiotic use points to an over-use of antimicrobials in COVID-19 patients.