Resumo Introdução: As informacoes relativas as caracteristicas clinicas e demograficas dos doentes portugueses hospitalizados com COVID-19 sao limitadas. Material e Métodos: Estudo ambispetivo dos doentes internados com COVID-19 num hospital terciario portugues entre marco e agosto de 2020. Foram excluidos os doentes assintomaticos, mulheres gravidas e os internados por causas sociais. Resultados: Dos 432 doentes internados, foram incluidos 279. A idade mediana foi de 69 anos, 57% do sexo masculino. As comorbilidades mais frequentes foram a hipertensao arterial (66,3%), dislipidemia (33,3%), diabetes (27,1%) e doenca cardiovascular (DCV) (26,5%). A sintomatologia mais frequente a admissao foi febre (74,4%), tosse (67,0%) e dispneia (59,9%). As alteracoes laboratoriais mais frequentes foram niveis elevados de ferritina (86,3%), proteina c-reativa (74,8%) e d-dimeros (73,9%). A taxa de mortalidade foi 17,3%, 32,3% dos doentes desenvolveram sindrome de dificuldade respiratoria aguda, 31,9% foram admitidos numa unidade de cuidados intensivos e 20,8% foram ventilados mecanicamente. Na analise multivariavel, a idade (OR 1,04, 95% CI 1,01-1,09, p=0,023), DCV (OR 2,68, 95% CI 1,21-5,93, p=0,015) e linfopenia <0,5x109/L (OR 6,61, 95% CI 2,23-19,62, p=0,001) identificaram-se como os principais fatores de risco de mortalidade intra-hospitalar. Discussão: Os nossos dados demograficos e desfechos clinicos equiparam-se aos estudos publicados ate a data. Em comparacao com os estudos em populacoes europeias, relatamos uma menor taxa de mortalidade intra-hospitalar, o que podera refletir um melhor controlo da primeira vaga da pandemia no nosso pais. Conclusão: Este estudo fornece informacao acerca das caracteristicas clinicas dos doentes com COVID-19 hospitalizados em Portugal.
Abstract Introduction: Clinical characteristics of Portuguese inpatients with coronavirus disease 2019 (COVID-19) are scarce. We aim to describe the demographic characteristics, clinical course and outcomes of hospitalized patients with COVID-19 and to analyze risk factors for in-hospital mortality. Material and Methods: Ambispective cohort study of adult COVID-19 patients admitted to a Portuguese tertiary hospital between March and August 2020. Asymptomatic, pregnant and all patients admitted due to social reasons were excluded. Results: Of the 432 admitted patients, 279 individuals were included. The median age was 69 years and 57% were male. The most common comorbidities were high blood pressure (66.3%), dyslipidemia (33.3%), diabetes (27.1%) and cardiovascular disease (CVD) (26.5%). The most common symptoms included fever (74.4%), cough (67.0%) and dyspnea (59.9%). Ferritin, C-reactive protein and D-dimer levels were elevated in 86.3%, 74.8% and 73.9% of patients, respectively. Mortality rate was 17.3%. 32.3% of the patients developed acute respiratory distress syndrome, 31.9% were admitted to intensive care unit and 20.8% were ventilated. In multivariable analysis, age (OR 1.04, 95% CI 1.01-1.09, p=0.023), CVD (OR 2.68, 95% CI 1.21-5.93, p=0.015) and lymphocyte count <0.5x109/L (OR 6.61, 95% CI 2.23-19.62, p=0.001) were risk factors for in-hospital mortality. Discussion: Our demographics, clinical and severity outcomes are in-line with international reports. Compared to other European countries, our less expressive in-hospital mortality rate might reflect a modestly controlled first outbreak in our country. Conclusion: This single-center study provides data on the clinical characteristics and outcomes of hospitalized patients with COVID-19 in Portugal.
