Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal

Detalhes bibliográficos
Autor(a) principal: Ricoca Peixoto, Vasco
Data de Publicação: 2023
Outros Autores: Vieira, André, Aguiar, Pedro, Carvalho, Carlos, Thomas, Daniel, Sousa, Paulo, Nunes, Carla, Abrantes, Alexandre
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/156144
Resumo: Copyright © 2023 Ricoca Peixoto, Vieira, Aguiar, Carvalho, Thomas, Sousa, Nunes and Abrantes.
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spelling Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugalpossible impact of healthcare burden and hospital bed occupancy on clinical management and outcomes, March-December 2020HumansFemaleCOVID-19/epidemiologyPortugal/epidemiologyBed OccupancyRetrospective StudiesIntensive Care UnitsDelivery of Health CareHospitalsSDG 3 - Good Health and Well-beingCopyright © 2023 Ricoca Peixoto, Vieira, Aguiar, Carvalho, Thomas, Sousa, Nunes and Abrantes.AIM: Identify factors associated with COVID-19 intensive care unit (ICU) admission and death among hospitalized cases in Portugal, and variations from the first to the second wave in Portugal, March-December 2020. INTRODUCTION: Determinants of ICU admission and death for COVID-19 need further understanding and may change over time. We used hospital discharge data (ICD-10 diagnosis-related groups) to identify factors associated with COVID-19 outcomes in two epidemic periods with different hospital burdens to inform policy and practice. METHODS: We conducted a retrospective cohort study including all hospitalized cases of laboratory-confirmed COVID-19 in the Portuguese NHS hospitals, discharged from March to December 2020. We calculated sex, age, comorbidities, attack rates by period, and calculated adjusted relative risks (aRR) for the outcomes of admission to ICU and death, using Poisson regressions. We tested effect modification between two distinct pandemic periods (March-September/October-December) with lower and higher hospital burden, in other determinants. RESULTS: Of 18,105 COVID-19 hospitalized cases, 10.22% were admitted to the ICU and 20.28% died in hospital before discharge. Being aged 60-69 years (when compared with those aged 0-49) was the strongest independent risk factor for ICU admission (aRR 1.91, 95%CI 1.62-2.26). Unlike ICU admission, risk of death increased continuously with age and in the presence of specific comorbidities. Overall, the probability of ICU admission was reduced in the second period but the risk of death did not change. Risk factors for ICU admission and death differed by epidemic period. Testing interactions, in the period with high hospital burden, those aged 80-89, women, and those with specific comorbidities had a significantly lower aRR for ICU admission. Risk of death increased in the second period for those with dementia and diabetes. DISCUSSION AND CONCLUSIONS: The probability of ICU admission was reduced in the second period. Different patient profiles were identified for ICU and deaths among COVID-19-hospitalized patients in different pandemic periods with lower and higher hospital burden, possibly implying changes in clinical practice, priority setting, or clinical presentation that should be further investigated and discussed considering impacts of higher burden on services in health outcomes, to inform preparedness, healthcare workforce planning, and pandemic prevention measures.Comprehensive Health Research Centre (CHRC) - Pólo ENSPEscola Nacional de Saúde Pública (ENSP)Centro de Investigação em Saúde Pública (CISP/PHRC)RUNRicoca Peixoto, VascoVieira, AndréAguiar, PedroCarvalho, CarlosThomas, DanielSousa, PauloNunes, CarlaAbrantes, Alexandre2023-08-01T22:20:26Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/156144eng2296-2565PURE: 67860678https://doi.org/10.3389/fpubh.2023.1215833info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:38:43Zoai:run.unl.pt:10362/156144Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:56:21.038634Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
possible impact of healthcare burden and hospital bed occupancy on clinical management and outcomes, March-December 2020
title Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
spellingShingle Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
Ricoca Peixoto, Vasco
Humans
Female
COVID-19/epidemiology
Portugal/epidemiology
Bed Occupancy
Retrospective Studies
Intensive Care Units
Delivery of Health Care
Hospitals
SDG 3 - Good Health and Well-being
title_short Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
title_full Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
title_fullStr Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
title_full_unstemmed Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
title_sort Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal
author Ricoca Peixoto, Vasco
author_facet Ricoca Peixoto, Vasco
Vieira, André
Aguiar, Pedro
Carvalho, Carlos
Thomas, Daniel
Sousa, Paulo
Nunes, Carla
Abrantes, Alexandre
author_role author
author2 Vieira, André
Aguiar, Pedro
Carvalho, Carlos
Thomas, Daniel
Sousa, Paulo
Nunes, Carla
Abrantes, Alexandre
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Escola Nacional de Saúde Pública (ENSP)
Centro de Investigação em Saúde Pública (CISP/PHRC)
RUN
dc.contributor.author.fl_str_mv Ricoca Peixoto, Vasco
Vieira, André
Aguiar, Pedro
Carvalho, Carlos
Thomas, Daniel
Sousa, Paulo
Nunes, Carla
Abrantes, Alexandre
dc.subject.por.fl_str_mv Humans
Female
COVID-19/epidemiology
Portugal/epidemiology
Bed Occupancy
Retrospective Studies
Intensive Care Units
Delivery of Health Care
Hospitals
SDG 3 - Good Health and Well-being
topic Humans
Female
COVID-19/epidemiology
Portugal/epidemiology
Bed Occupancy
Retrospective Studies
Intensive Care Units
Delivery of Health Care
Hospitals
SDG 3 - Good Health and Well-being
description Copyright © 2023 Ricoca Peixoto, Vieira, Aguiar, Carvalho, Thomas, Sousa, Nunes and Abrantes.
publishDate 2023
dc.date.none.fl_str_mv 2023-08-01T22:20:26Z
2023
2023-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/156144
url http://hdl.handle.net/10362/156144
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2296-2565
PURE: 67860678
https://doi.org/10.3389/fpubh.2023.1215833
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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