Comorbidade cardiovascular como preditor de complicações em pacientes hospitalizados com Covid-19
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Objetivo: Avaliar a associação entre as características clínicas e a gravidade da Covid-19. Métodos: Foram incluídos adultos hospitalizados com Covid-19 confirmada por reação em cadeia da polimerase com transcrição reversa (RT-PCR), entre março e junho de 2020. Avaliamos o estado de saúde dos pacientes durante a internação hospitalar. Coletamos dados demográficos, clínicos e laboratoriais e realizamos análise de regressão linear multivariada para determinar variáveis preditoras dos desfechos (tempo de internação, necessidade de terapia intensiva e uso de ventilação mecânica). Para este estudo, definimos comorbidade cardiovascular como a presença de doença arterial coronariana, fibrilação atrial ou valvopatias. Resultados: A amostra total do estudo consistiu de 221 pacientes, com média de idade de 53,7 ± 16,0 anos, sendo 57% (n = 126) do sexo masculino. Após ajuste por idade e saturação de oxigênio, indivíduos com doença cardiovascular apresentaram maior tempo de internação hospitalar (23,5 versus 13,5 dias; p < 0,008; β = 0,175; IC95% 2,33–17,14), maior tempo em unidade de terapia intensiva (18,8 versus 7,7 dias; p < 0,002; β = 0,195; IC95% 3,47–16,67) e maior duração de ventilação mecânica (9,7 versus 4,0 dias; p < 0,02; β = 0,148; IC95% 0,64–10,58) em comparação com indivíduos sem doença cardiovascular. A presença de doença cardiovascular e a saturação de oxigênio estiveram associadas, de forma independente, a desfechos adversos na análise de regressão multivariada. Conclusão: Pacientes com comorbidades cardiovasculares apresentam maior risco de desenvolver formas graves da Covid-19. Esses achados podem ser úteis na previsão de complicações e na orientação de cuidados personalizados para indivíduos com síndromes respiratórias graves.
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Referências
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