Dados do Trabalho

Título

Lessons learned about Acute Respiratory Distress Syndrome in a Brazilian university center during the COVID-19 pandemic

Objetivo

Objective: Management strategies in Acute Respiratory Distress Syndrome (ARDS) due to COVID-19 were comparatively analyzed between the first and second wave.

Métodos

Method: Prospective study where we analyzed the clinical profile, outcomes and treatment in hospitalized patients.

Resultados

Results: Among 176 patients, 95 were from the first and 81 from the second wave. Mortality was 35.8%, being 47.4% vs. 22.2% (p=0.001), respectively. Median age was 55 years [IQR:46–58], with no difference between waves. There was a tendency towards a greater number of comorbidities (≥2 comorbidities) in the first wave (p=0,051).The Sequential Organ Failure Assessment (SOFA) was higher in the first wave, median of 4[IQR: 3;7.7] vs. 3[IQR: 2;5.5], and 5[IQR: 3;8] vs. 3[IQR: 2;7], at 24 and 72 hours, respectively (p=0.001). Patients in the first wave received more invasive mechanical ventilation (IMV), 68.4% vs. 45.7% (p=0.002) and hemodialysis, 49.5% vs. 17.7% (p=0.000), but less non-invasive ventilation (NIV), 8.4% vs. 72.5% (p=0.000), and corticosteroids, 86.6% vs. 96.6% (p=0.02). No one was vaccinated in the first wave, while only 7 patients had 20 received a full vaccine in the second wave.

Conclusão

Conclusion: Patients with ARDS had lower mortality, fewer organ dysfunctions and less need for IMV and hemodialysis, with greater use of NIV and corticosteroids in the second wave.