Dados do Trabalho

Título

Assessment of excess mortality due to severe SARS-COV-2 infection in public and private Intensive Care Units in Brazil: A Multicenter Retrospective Cohort Study

Objetivo

To address the excess or burden of critically ill COVID-19 patients compared to a general case mix of intensive care unit (ICU) patients without SARS-CoV-2 infection. Additionally, we compared outcomes between COVID-19 patients admitted to public and private ICUs.

Métodos

Multicenter retrospective cohort study. Adult patients admitted to two public and two private ICUs between January 2018 and December 2021 were included. Comparisons were performed between COVID-19 vs. non-COVID-19 patients and between COVID-19 patients admitted to public vs. private hospitals. Primary outcome was hospital mortality.

Resultados

A total of 21115 non-COVID-19 patients and 5790 COVID-19 patients (3321 admitted to private and 2469 admitted to public hospitals) were analyzed. COVID-19 patients were younger, had a higher SAPS III score, used non-invasive ventilation (NIV; 54% vs. 12%; p<0.001), mechanical ventilation (MV; 46% vs. 20%, p<0.001), vasopressors (38% vs. 29%; p<0.001), renal replacement therapy (RRT; 17% vs. 8%; p<0.001) more frequently and exhibited a higher hospital mortality (26.6% vs. 13.5%; aOR: 2.3; 95%CI: 2.1-2.4; p<0.001) compared to non-COVID-19 patients. COVID-19 patients admitted to public ICUs showed a higher SAPS III score, received MV, vasopressors and RRT more frequently and had a higher hospital mortality (40.3% vs. 16.4%; aOR: 3.6; 95%CI: 3.2-4.1; p<0.001) compared to private ICUs.

Conclusão

Despite being younger, COVID-19 patients were sicker, required more organ support, and had worse clinical outcomes compared to non-COVID-19 critically ill patients. Moreover, disparities were found regarding resource use and outcomes between COVID-19 patients admitted to public and private ICUs hospitals.