Prevalence of comorbidities in Severe Acute Respiratory Syndrome in patients with COVID-19 and other infectious agentes
DOI:
https://doi.org/10.33448/rsd-v9i11.10286Keywords:
SARS; COVID-19; Pernambuco State; Northeast; Brazil.Abstract
This study aimed to analyze the cases of acute respiratory syndrome - SARS caused by COVID-19, or not, in relation to the presence of heart diseases and diabetes, in severe cases in the State of Pernambuco, the Northeast region and in Brazil. Data were collected from the Ministry of Health's OpenDataSUS Database, covering information between 12/29/2019 and 9/14/2020. Analyzes were made with the rpart package of the R software, which builds classification or regression models that can be represented as binary trees. The results revealed a significant percentage of heart diseases and diabetes (average of 51% and 40%, respectively) present in patients with SARS, regardless of etiology, in the three areas considered. It was also observed that patients with heart disease develop SARS more frequently when affected with COVID-19 (64.6%) than with other etiologies (35.4%). The same was observed for diabetic patients with COVID-19 (67.1%) and for patients negative for COVID-19 (27.7%). The lethality rate was higher among patients with both comorbidities. It was 47.6% for diabetes; 45.3% for cardiac patients and 50.3% when in combination in patients affected by SARS caused by COVID-19. The results obtained are relevant to the development of public health measures seeking to identify patients at higher risk and to apply early and specific treatments in order to reduce mortality in these cases.
References
Abdel-Ghafar, A. N., Chotpitayasunondh, T., Gao, Z., Hayden, F. G., Nguyen, D. H., de Jong, M. D., Naghdaliyev, A., Peiris, J. S., Shindo, N., Soeroso, S., & Uyeki, T. M. (2008). Update on avian influenza A (H5N1) virus infection in humans. The New England journal of medicine, 358(3), 261–273. https://doi.org/10.1056/NEJMra0707279.
Badawi, A., Sayegh, S., Sallam, M., Sadoun, E., Al-Thani, M., Alam, M. W. and Arora, P. (2015) The global relationship between the prevalence of diabetes mellitus and incidence of tuberculosis: 2000-2012. Global Journal of Health Science 7. 37557. 10.5539/gjhs.v7n2p183.
Breiman L., Friedman J. H., Olshen R. A., & Stone C. J. (1983). Classification and Regression Trees. Wadsworth, Belmont, Ca.
Clark L. A., & Pregibon D. (1992). Tree-based models. In J. M. Chambers & T. J. Hastie, editors, Statistical Models in S, chapter 9. Wadsworth and Brooks/Cole, Pacific Grove, Ca.
Corrales-Medina, V. F., Musher, D. M., Shachkina, S., & Chirinos, J. A. (2013). Acute pneumonia and the cardiovascular system. Lancet (London, England), 381(9865), 496–505. https://doi.org/10.1016/S0140-6736(12)61266-5.
Ison, GM. MD, MSc. Respiratory Viral Infections. SAM. [The original English language work has been published by Decker Intellectual Properties INC. Hamilton, Ontario, Canada. Copyright © 2015 Decker Intellectual Properties Inc. All Rights Reserved.]
Kulcsar, K. A., Coleman, C. M., Beck, S. E. and Frieman, M. B. (2019) Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection. JCI insight. https://doi.org/10.1172/jci.insight.131774.
LeBlanc, M., & Crowley, J. (1992). Relative Risk Trees for Censored Survival Data. Biometrics, 48(2), 411-425. doi:10.2307/2532300.
Lee N, Hui D, Wu A, Chan P., Cameron P., Joynt G. M., Ahuja, A., Yung, M. Y., Leung C.B., To K.F., Lui S.F., Szeto C.C., Chung S., Sung J. J.Y. (2003). A major outbreak of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine. 348, 1986-94. https://doi.org/10.1056/NEJMoa030685.
Lippi G, Sanchis-Gomar F, Henry B. M. (2020). Response to: Is newly diagnosed diabetes a stronger risk factor than pre-existing diabetes for COVID-19 severity? Journal of Diabetes. https://doi.org/10.1111/1753-0407.13127.
Organization WH (2020). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Recuperado de https://www.who.int/docs/defaultsource/coronaviruse/ who-china-joint-mission-on-covid-19-final-report.pdf. Acesso em: 12 de novembro de 2020.
Palaiodimos, L., Chamorro-Pareja, N., Karamanis, D., Li, W., Zavras, P. D., Chang, K. M., Mathias, P., Kokkinidis, D. G. (2020). Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients. Hormones (Athens). medRxiv. https://doi.org/10.1101/2020.05.26.20113811
Poutanen, S. M., Low, D. E., Henry, B., Finkelstein S., Rose, D., Green, K., Tellier, R., Draker, R., Adachi, D., Ayers, M., Chan, A. K., Skowronski, D. M., Salit, I., Simor, A. E., Slutsky, A. S., Doyle, P. W., Krajden, M., Petric, M., Brunham, R. C., McGeer, A. J. (2003). Identification of Severe Acute Respiratory Syndrome in Canada. New England Journal of Medicine. 348, 1995-2005. https://doi.org/10.1056/NEJMoa030634.
Ribeiro, I. G., & Sanchez, M. N. (2020). Avaliação do sistema de vigilância da síndrome respiratória aguda grave (SRAG) com ênfase em influenza, no Brasil, 2014 a 2016. Epidemiologia e Serviços de Saúde, 29(3), e2020066. Epub 12 de junho de 2020. https://doi.org/10.5123/s1679-49742020000300013.
Sepandi M., Taghdir M., Alimohamadi, A. S., Hosamirudsari H. (2020). Factors Associated with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Iran J Public Health. 49(7), 1211-1221. https://doi.org/10.18502/ijph.v49i7.3574.
Therneau, T. M., & Atkinson, E. J. (1997). An introduction to recursive partitioning using the rpart routines. Divsion of Biostatistics 61, Mayo Clinic.
Tsang, K. W., Ho, P. L., Ooi, G. C., Yee, W. K., Wang, T., Chan-Yeung, M., Lam, W. K., Seto, W. H., Yam, L. Y., Cheung, T. M., Wong, P. C., Lam, B., Ip, M. S., Chan, J., Yuen, K. Y., & Lai, K. N. (2003). A cluster of cases of severe acute respiratory syndrome in Hong Kong. The New England journal of medicine, 348(20), 1977–1985. https://doi.org/10.1056/NEJMoa030666.
Udell, J. A., Zawi, R., Bhatt, D. L., Keshtkar-Jahromi, M., Gaughran, F., Phrommintikul, A., Ciszewski, A., Vakili, H., Hoffman, E. B., Farkouh, M. E., & Cannon, C. P. (2013). Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA, 310(16), 1711–1720. https://doi.org/10.1001/jama.2013.279206.
Wang D., Hu B., Hu C., Zhu, F., Liu X., Zhang J.,Wang B., Xiang H., Cheng, Z., Xiong Y., Zhao Y., Li Y., Wang X., Peng Z. (2020). Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. https://doi.org/10.1001/jama.2020.1585.
Wu, Z., McGoogan, J. M. (2019). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. https://doi.org/10.1001/jama.2020.2648.
Yang, Y., Chen, X. F. D., Chen, Y., Xie, H., Xie, C., Ying, L. (2020). The influence of hypoglycemia and hyperglycemia on the adverse outcome of COVID-19 combined with diabetes mellitus: A protocol for systematic review and meta-analysis. Medicine (Baltimore). doi: https://doi.org/10.1097/MD.0000000000022587.
Zhao, Z., Zhang, F., Xu, M., Huang, K., Zhong, W., Cai, W., Yin, Z., Huang, S., Deng, Z., Wei, M., Xiong, J., & Hawkey, P. M. (2003). Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China. Journal of medical microbiology, 52(Pt 8), 715–720. https://doi.org/10.1099/jmm.0.05320-0.
Zhong, N. S., Zheng, B. J., Li, Y. M., Poon, Xie, Z. H., Chan, K. H., Li, P. H., Tan, S. Y., Chang, Q., Xie, J. P., Liu, X. Q., Xu, J., Li, D. X., Yuen, K. Y., Peiris, & Guan, Y. (2003). Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003. Lancet (London, England), 362(9393), 1353–1358. https://doi.org/10.1016/s0140-6736(03)14630-2.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. doi: 10.1016/S0140-6736(20)30566-3.
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Copyright (c) 2020 Dâmocles Aurélio Nascimento da Silva Alves; Gabriela Isabel Limoeiro Alves Nascimento; Elisângela Ramos Castanha; José Elizângelo Lopes Luna; Eryka Fernanda Miranda Sobral; Wanderberg Alves Brandão ; Keila Aparecida Moreira; Josiete da Silva Mendes; Moacyr Cunha Filho; Dherfferson Montini Barros; Rosângela Estevão Alves Falcão
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