Monitoramento da COVID-19 em trabalhadores de uma universidade pública brasileira: um estudo de coorte retrospectivo
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2023.208895Palavras-chave:
Epidemiologia, COVID-19, SARS-CoV-2, Atenção primária à saúdeResumo
Introdução: as estratégias de ação da atenção primária são relevantes para a prevenção de doenças e promoção da saúde, bem como para o manejo inicial de casos suspeitos e acompanhamento individual de pacientes com diagnóstico confirmado de COVID-19. Este estudo teve como objetivo avaliar o desfecho da piora clínica e variáveis demográficas, ocupacionais e clínicas de trabalhadores com COVID-19 em um centro comunitário de saúde de uma universidade pública do sudeste do Brasil. Métodos: estudo de coorte retrospectivo com 1.459 trabalhadores sintomáticos com COVID-19. Os dados foram extraídos do banco de dados do núcleo de vigilância epidemiológica da unidade entre março de 2020 e março de 2021. Resultados: A média de idade dos participantes foi de 41,1 (DP 10,8) anos, sendo a maioria mulheres (71,1%), com obesidade (19,9%) e hipertensão (17,0%). Dentre os sintomas, destacaram-se a cefaleia (75,3%) e a tosse (74,9%). A piora do quadro clínico durante o seguimento ocorreu em 3,4% dos casos. Os fatores demográficos, ocupacionais e clínicos associados à piora clínica foram sexo, categoria profissional, hipertensão arterial, diabetes mellitus, obesidade, dislipidemia, distúrbios do olfato, tosse, febre e dispneia. A regressão de Poisson mostrou que a prevalência de piora clínica foi maior com a idade, obesidade, febre
e dispneia. Conclusão: A piora clínica ocorreu em 3,4% dos casos e foi mais prevalente conforme idade, obesidade, febre e dispneia. O acompanhamento mostrou-se promissor na detecção precoce e no tratamento da COVID-19.
Downloads
Referências
Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA 2020; 324(8):782–93. https://doi.org/10.1001/jama.2020.12839
World Health Organization. Coronavirus disease (COVID-19) pandemic. WHO Coronavirus (COVID-19) Dashboard (2023a). Available at: https://covid19.who.int/
Burki T. COVID-19 in Latin America. Lancet Infect Dis 2020; 20(5):547-48. https://doi.org/10.1016/S1473-3099(20)30303-0
Brasil. Ministério da Saúde. Painel Coronavírus 2023. Available at: https://covid.saude.gov.br/ (Original work published in Portuguese).
Li J, Huang DQ, Zou B, Yang H, Hui WZ, Rui F, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol 2021; 93(3): 1449–58. https://doi.org/10.1002/jmv.26424
Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol 2021;19(3):141–54. https://doi.org/10.1038/s41579-020-00459-7
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13):1239-42. https://doi.org/10.1001/jama.2020.2648
Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. The Am J Emerg Med 2020; 38(7):1504–7. https://doi.org/10.1016/j.ajem.2020.04.048
Aghagoli G, Gallo Marin B, Soliman LB, Sellke F W. Cardiac involvement in COVID-19 patients: Risk factors, predictors, and complications: A review. J Card Surg 2020; 35(6):1302–5. https://doi.org/10.1111/jocs.14538
Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021; 397 (10270): 220-32. https://doi.org/10.1016/S0140-6736(20)32656-8
Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ 2020; 370: m3026. https://doi.org/10.1136/bmj.m3026
BRASIL. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Protocolo de Manejo Clínico do Coronavírus (COVID-19) na Atenção Primária à Saúde, versão 7. Brasília – DF, Abril de 2020. Available at: https://saude.rs.gov.br/upload/arquivos/202004/14140606-4-ms-protocolomanejo-aps-ver07abril.pdf (Original work published in Portuguese).
Pagano M, Gauvreau K. Principles of Bioestatistics, Ed. Thomson, São Paulo, 2004.
Mehta C, Patel N. A network algorithm for performing Fisher's exact test in r × c contingency tables. J Am Stat Assoc 1983; 78(382):427-34. https://doi.org//10.2307/2288652
Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004; 159(7):702-6. https://doi.org/10.1093/aje/kwh090
Rodríguez-Molinero A, Gálvez-Barrón C, Miñarro A, Macho O, López GF, Robles MT, et al, Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients. PloS one 2020;15(10): e0239571. https://doi.org/10.1371/journal.pone.0239571
Brodin P. Immune determinants of COVID-19 disease presentation and severity. Nature medicine, 27(1), 28–33. https://doi.org/10.1038/s41591-020-01202-8
Buonafine CP, Paiatto B, Leal FB, de Matos SF, de Morais CO, Guerra GG, et al. High prevalence of SARS-CoV-2 infection among symptomatic healthcare workers in a large university tertiary hospital in São Paulo, Brazil. BMC Infect Dis 2020; 20(1): 917. https://doi.org/10.1186/s12879-020-05662-8
Gómez-Ochoa SA, Franco OH, Rojas LZ, Raguindin PF, Roa-Díaz ZM, Wyssmann BM, et al. COVID-19 in health-care workers: a living systematic review and meta-Analysis of prevalence, risk factors, clinical characteristics, and outcomes. Am J Epidemiol 2021;190(1): 161–75. https://doi.org/10.1093/aje/kwaa191
World Health Organization. Noncommunicable diseases progress monitor 2020. Geneva: WHO; 2020. Available at: https://www.who.int/publications-detail/ncd-progress-monitor-2020
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, the Northwell COVID-19 Research Consortium, Barnaby DP, Becker LB, Chelico, JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Zanos TP. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA 2020; 323(20):2052-9. https://doi.org/10.1001/jama.2020.6775
Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 Pandemic. JACC 2020; 75(18): 2352–71. https://doi.org/10.1016/j.jacc.2020.03.031
Burn E, Tebé C, Fernandez-Bertolin S, Aragon M, Recalde M, Roel E, et al. The natural history of symptomatic COVID-19 during the first wave in Catalonia. Nat Commun 2021; 12(1): 777. https://doi.org/10.1038/s41467-021-21100-y
Chen Y, Klein SL, Garibaldi BT, Li H, Wu C, Osevala NM, et al. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev 2021; 65:101205. https://doi.org/10.1016/j.arr.2020.101205
Finer N, Garnett SP, Bruun JM. COVID-19 and obesity. Clin Obes 2020; 10(3): e12365. https://doi.org/10.1111/cob.12365
Popkin BM, Du S, Green WD, Beck MA, Algaith T, Herbst CH, Alsukait RF, Alluhidan M, Alazemi N, Shekar M. Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships. Obes Rev, 2020; 21(11): e13128. https://doi.org/10.1111/obr.13128
World Health Organization. Coronavirus disease (COVID-19) pandemic. Geneva: WHO; 2019 Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Shi Y, Wang G, Cai XP, Deng JW, Zheng L, Zhu HH, Zheng M, Yang B, Chen Z. An overview of COVID-19. J Zhejiang Univ Sci B. 2020;21(5):343-60. https://doi.org/10.1631/jzus.B2000083
Blazey-Martin D, Barnhart E, Jr JG, Vazquez GA. Primary care population management for COVID-19 Patients. J Gen Intern Med 2020; 35(10):3077–80. https://doi.org/10.1007/s11606-020-05981-1
Sohrabi MR, Amin R, Maher A, Bahadorimonfared A, Janbazi S, Hannani K, et al. Sociodemographic determinants and clinical risk factors associated with COVID-19 severity: a cross-sectional analysis of over 200,000 patients in Tehran, Iran. BMC Infect Dis 2021; 21(1): 474. https://doi.org/10.1186/s12879-021-06179-4
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2023 Leila Tassia Pagamicce, Carla Renata Silva Andrechuk, Mariane Karin de Moraes Oliveira , Edite Kazue Taninaga , Inajara de Cassia Guerreiro , Maria Helena Postal Pavan , Rose Clélia Grion Trevisane , Roberta Cunha Matheus Rodrigues
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
