This study aims to assess the risk of severe forms of COVID-19, based on clinical, laboratory, and imaging markers in patients initially admitted to the ward. This is a retrospective observational study, with data from electronic medical records of inpatients, with laboratory confirmation of COVID-19, between March and September 2020, in a hospital from Juiz de Fora-MG, Brazil. Participants (n = 74) were separated into two groups by clinical evolution: those who remained in the ward and those who progressed to the ICU. Mann–Whitney U test was taken for continuous variables and the chi-square test or Fisher’s exact test for categorical variables. Comparing the proposed groups, lower values of lymphocytes ( p = <0.001) and increases in serum creatinine ( p = 0.009), LDH ( p = 0.057), troponin ( p = 0.018), IL-6 ( p = 0.053), complement C4 ( p = 0.040), and CRP ( p = 0.053) showed significant differences or statistical tendency for clinical deterioration. The average age of the groups was 47.9 ± 16.5 and 66.5 ± 7.3 years ( p = 0.001). Hypertension ( p = 0.064), heart disease ( p = 0.048), and COPD ( p = 0.039) were more linked to ICU admission, as well as the presence of tachypnea on admission ( p = 0.051). Ground-glass involvement >25% of the lung parenchyma or pleural effusion on chest CT showed association with evolution to ICU ( p = 0.027), as well as bilateral opacifications ( p = 0.030) when compared to unilateral ones. Laboratory, clinical, and imaging markers may have significant relation with worse outcomes and the need for intensive treatment, being helpful as predictive factors.
Introduction The effects, severity, and prognosis of COVID-19 infections do not follow a linear pattern in different locations, but change according to the epidemiological data and social issues in each region. Aims The purpose of the current study is to provide the clinical and epidemiological standard of the population affected by COVID-19 in the city of Juiz de Fora, MG to better understand the disease and its risk factors, in order to enable more appropriate conduct for patients. Methods A retrospective observational study was carried out from March to August of 2020, with 266 participants admitted to the emergency department of the Instituto de Clínicas e Cirurgia de Juiz de Fora—Hospital Monte Sinai. Data were tabulated, analyzed, and classified according to the outcome using an ordinal regression model. Results Among the 266 admitted patients, the most common findings were ground-glass opacifications on chest CT (78.8%), cough (75.6%), fever (58.4%), and rhinorrhea (34.5%). There were greater severity and greater need for hospitalization and admission to the ICU in patients who were male, tachypneic at the time of admission, with older age, and with underlying diseases. Conclusion Collected data allowed for a better understanding of the disease, its severity criteria, and its pattern of affection in Juiz de Fora, MG. More studies based on the analysis of the behavior of COVID-19 in different regions must be carried out, to improve treatment and support to local populations.
BACKGROUND: Sexually transmitted diseases (STIs) are an important public health problem in all countries. Knowledge of their relationship with the various socioeconomic levels is necessary for an understanding of their epidemiology and behavior in society. OBJECTIVE: To investigate the epidemiology of human immunodeficiency virus (HIV)-positive patients and to correlate education with history of sexually transmitted diseases, especially for syphilis. DESIGN AND SETTING: Analytical cross-sectional study carried out in the city of Juiz de Fora, Minas Gerais, Brazil. METHODS: The medical records of HIV/acquired immunodeficiency syndrome (AIDS) patients who started antiretroviral therapy (ART) between January 2010 and July 2018 were assessed. These patients were attended at the specialized assistance service for HIV/AIDS) of the Department of Sexually Transmitted Diseases (STD/AIDS) of the city of Juiz de Fora. In total, 335 patients were selected. RESULTS: In our sample, 73.13% were male; 57.36% were aged between 25 and 45 years and 24.23% were over 45 years of age. Regarding sexual orientation, 61.78% were homosexual. Regarding education, 52.88% had "unskilled education", while 47.12% had "qualified education". Analysis on the relationship between schooling and syphilis, a positive relationship between qualified schooling and syphilis was observed: odds ratio = 3.588; 95% confidence interval: 1.090-11.808. CONCLUSION: Homosexual male patients are most affected by HIV. Furthermore, this disease is not limited only to individuals with low education. Syphilis should be suspected in all individuals.
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