ABSTRACT Objective: To analyze the factors associated with hospitalization in the ward and intensive care unit (ICU), and with death from COVID-19 in pregnant women with confirmed cases. Methods: Observational, cross-sectional study, carried out with data from pregnant women with a confirmed case of COVID-19 from the Influenza Epidemiological Surveillance Information System and the Paraná’s state COVID-19 notification system. The association between the independent and dependent variables (hospitalization in the ward and ICU, and death) was investigated using the Poisson regression model with robust variance. Results: 4,719 pregnant women comprised the study population. 9.6 and 5.1% were hospitalized in wards and ICU, respectively. 1.9% died. There was an association between advanced maternal age and hospitalization in wards (PR=1.36; 95%CI 1.10–1.62) and ICU (PR=2.25; 95%CI 1.78–2.71), and death (PR=3.22; 95%CI 2.30–4.15). An association was found between the third trimester and hospitalization in wards (PR=5.06; 95%CI 2.82–7.30) and ICU (PR=6.03; 95%CI 3.67–8.39) and death (PR=13.56; 95%CI 2.90–24.23). The second trimester was associated with ICU admission (PR=2.67; 95%CI 1.36–3.99). Pregnant women with cardiovascular disease had a higher frequency of hospitalization in wards (PR=2.24; 95%CI 1.43–3.05) and ICU (PR=2.66; 95%CI 1.46–3.87). Obesity was associated with ICU admission (PR=3.79; 95%CI 2.71–4.86) and death (PR=5.62; 95%CI 2.41–8.83). Conclusions: Advanced maternal age, the end of the gestational period and comorbidities were associated with severe COVID-19. Objective , (ICU) COVID19 COVID 19 COVID-1 cases Methods Observational crosssectional cross sectional Paranás Paraná s system variance Results 4719 4 719 4,71 population 96 9 6 9. 51 5 1 5.1 respectively 1.9 died PR=1.36 PR136 PR 36 (PR=1.36 95CI CI 95 1.10–1.62 110162 10 62 PR=2.25 PR225 2 25 (PR=2.25 1.78–2.71, 178271 1.78–2.71 78 71 1.78–2.71) PR=3.22 PR322 3 22 (PR=3.22 2.30–4.15. 230415 2.30–4.15 . 30 15 2.30–4.15) PR=5.06 PR506 06 (PR=5.06 2.82–7.30 282730 82 7 PR=6.03 PR603 03 (PR=6.03 3.67–8.39 367839 67 8 39 PR=13.56 PR1356 13 56 (PR=13.56 2.90–24.23. 2902423 2.90–24.23 90 24 23 2.90–24.23) PR=2.67 PR267 (PR=2.67 1.36–3.99. 136399 1.36–3.99 99 1.36–3.99) PR=2.24 PR224 (PR=2.24 1.43–3.05 143305 43 05 PR=2.66 PR266 66 (PR=2.66 1.46–3.87. 146387 1.46–3.87 46 87 1.46–3.87) PR=3.79 PR379 79 (PR=3.79 2.71–4.86 271486 86 PR=5.62 PR562 (PR=5.62 2.41–8.83. 241883 2.41–8.83 41 83 2.41–8.83) Conclusions COVID19. 19. (ICU COVID1 COVID- 471 4,7 5. 1. PR=1.3 PR13 (PR=1.3 1.10–1.6 11016 PR=2.2 PR22 (PR=2.2 17827 1.78–2.7 PR=3.2 PR32 (PR=3.2 23041 2.30–4.1 PR=5.0 PR50 0 (PR=5.0 2.82–7.3 28273 PR=6.0 PR60 (PR=6.0 3.67–8.3 36783 PR=13.5 PR135 (PR=13.5 290242 2.90–24.2 PR=2.6 PR26 (PR=2.6 13639 1.36–3.9 1.43–3.0 14330 14638 1.46–3.8 PR=3.7 PR37 (PR=3.7 2.71–4.8 27148 PR=5.6 PR56 (PR=5.6 24188 2.41–8.8 47 4, PR=1. PR1 (PR=1. 1.10–1. 1101 PR=2. PR2 (PR=2. 1782 1.78–2. PR=3. PR3 (PR=3. 2304 2.30–4. PR=5. PR5 (PR=5. 2.82–7. 2827 PR=6. PR6 (PR=6. 3.67–8. 3678 PR=13. (PR=13. 29024 2.90–24. 1363 1.36–3. 1.43–3. 1433 1463 1.46–3. 2.71–4. 2714 2418 2.41–8. PR=1 (PR=1 1.10–1 110 PR=2 (PR=2 178 1.78–2 PR=3 (PR=3 230 2.30–4 PR=5 (PR=5 2.82–7 282 PR=6 (PR=6 3.67–8 367 PR=13 (PR=13 2902 2.90–24 136 1.36–3 1.43–3 143 146 1.46–3 2.71–4 271 241 2.41–8 PR= (PR= 1.10– 11 17 1.78– 2.30– 2.82– 28 3.67– 290 2.90–2 1.36– 1.43– 14 1.46– 2.71– 27 2.41– (PR 1.10 1.78 2.30 2.82 3.67 29 2.90– 1.36 1.43 1.46 2.71 2.41 1.1 1.7 2.3 2.8 3.6 2.90 1.3 1.4 2.7 2.4 2. 3. 2.9
RESUMO Objetivo: Analisar os fatores associados à hospitalização em enfermaria e unidade de terapia intensiva (UTI), e ao óbito pela COVID-19 em gestantes com caso confirmado. Métodos: Pesquisa observacional, transversal, realizada com dados de gestantes com caso confirmado para COVID-19 provenientes do Sistema de Informação de Vigilância Epidemiológica da Gripe e do Sistema Estadual Notifica COVID-19, do Paraná. Investigou-se a associação entre variáveis independentes e dependentes (hospitalização em enfermaria e UTI, e óbito) pelo modelo de regressão de Poisson com variância robusta. Resultados: 4.719 gestantes compuseram a população do estudo; 9,6 e 5,1% foram hospitalizadas em enfermaria e UTI, respectivamente; 1,9% evoluíram para óbito. Houve associação entre a idade materna avançada e internação em enfermaria (RP=1,36; IC95% 1,10–1,62) e UTI (RP=2,25; IC95% 1,78–2,71), e óbito (RP=3,22; IC95% 2,30–4,15). Verificou-se associação entre o terceiro trimestre gestacional e hospitalização em enfermaria (RP=5,06; IC95% 2,82–7,30) e UTI (RP=6,03; IC95% 3,67–8,39) e óbito (RP=13,56; IC95% 2,90–24,23). O segundo trimestre associou-se à internação em UTI (RP=2,67; IC95% 1,36–3,99). Gestantes com cardiopatia apresentaram maior frequência de hospitalização em enfermaria (RP=2,24; IC95% 1,43–3,05) e UTI (RP=2,66; IC95% 1,46–3,87). A obesidade foi associada à admissão em UTI (RP=3,79; IC95% 2,71–4,86) e ao óbito (RP=5,62; IC95% 2,41–8,83). Conclusão: A idade materna avançada, o final do período gestacional e comorbidades foram fatores associados a quadros graves de COVID-19. Objetivo , (UTI) COVID19 COVID 19 COVID-1 Métodos observacional transversal COVID19, 19, Paraná Investigouse Investigou se robusta Resultados 4719 4 719 4.71 estudo 96 9 6 9, 51 5 1 5,1 respectivamente 1,9 RP=1,36 RP136 RP 36 (RP=1,36 IC95 IC 1,10–1,62 110162 10 62 RP=2,25 RP225 2 25 (RP=2,25 1,78–2,71, 178271 1,78–2,71 78 71 1,78–2,71) RP=3,22 RP322 3 22 (RP=3,22 2,30–4,15. 230415 2,30–4,15 . 30 15 2,30–4,15) Verificouse Verificou RP=5,06 RP506 06 (RP=5,06 2,82–7,30 282730 82 7 RP=6,03 RP603 03 (RP=6,03 3,67–8,39 367839 67 8 39 RP=13,56 RP1356 13 56 (RP=13,56 2,90–24,23. 2902423 2,90–24,23 90 24 23 2,90–24,23) associouse associou RP=2,67 RP267 (RP=2,67 1,36–3,99. 136399 1,36–3,99 99 1,36–3,99) RP=2,24 RP224 (RP=2,24 1,43–3,05 143305 43 05 RP=2,66 RP266 66 (RP=2,66 1,46–3,87. 146387 1,46–3,87 46 87 1,46–3,87) RP=3,79 RP379 79 (RP=3,79 2,71–4,86 271486 86 RP=5,62 RP562 (RP=5,62 2,41–8,83. 241883 2,41–8,83 41 83 2,41–8,83) Conclusão COVID19. 19. (UTI COVID1 COVID- 471 4.7 5, 1, RP=1,3 RP13 (RP=1,3 IC9 1,10–1,6 11016 RP=2,2 RP22 (RP=2,2 17827 1,78–2,7 RP=3,2 RP32 (RP=3,2 23041 2,30–4,1 RP=5,0 RP50 0 (RP=5,0 2,82–7,3 28273 RP=6,0 RP60 (RP=6,0 3,67–8,3 36783 RP=13,5 RP135 (RP=13,5 290242 2,90–24,2 RP=2,6 RP26 (RP=2,6 13639 1,36–3,9 1,43–3,0 14330 14638 1,46–3,8 RP=3,7 RP37 (RP=3,7 2,71–4,8 27148 RP=5,6 RP56 (RP=5,6 24188 2,41–8,8 47 4. RP=1, RP1 (RP=1, 1,10–1, 1101 RP=2, RP2 (RP=2, 1782 1,78–2, RP=3, RP3 (RP=3, 2304 2,30–4, RP=5, RP5 (RP=5, 2,82–7, 2827 RP=6, RP6 (RP=6, 3,67–8, 3678 RP=13, (RP=13, 29024 2,90–24, 1363 1,36–3, 1,43–3, 1433 1463 1,46–3, 2,71–4, 2714 2418 2,41–8, RP=1 (RP=1 1,10–1 110 RP=2 (RP=2 178 1,78–2 RP=3 (RP=3 230 2,30–4 RP=5 (RP=5 2,82–7 282 RP=6 (RP=6 3,67–8 367 RP=13 (RP=13 2902 2,90–24 136 1,36–3 1,43–3 143 146 1,46–3 2,71–4 271 241 2,41–8 RP= (RP= 1,10– 11 17 1,78– 2,30– 2,82– 28 3,67– 290 2,90–2 1,36– 1,43– 14 1,46– 2,71– 27 2,41– (RP 1,10 1,78 2,30 2,82 3,67 29 2,90– 1,36 1,43 1,46 2,71 2,41 1,1 1,7 2,3 2,8 3,6 2,90 1,3 1,4 2,7 2,4 2, 3, 2,9