Abstract
Objective: Evaluate the clinical and care profile and fármaco therapy used by patients in COVID-19 intensive care units. Methods: This is a cross-sectional, descriptive study carried out in a public hospital thatis a regional reference for emergency care, located in the South West of Bahia. Data were collected from medical records of patients diagnosed with COVID-19 and admitted to the ICUs in 2020 and 2021. The drugs analyzed were classified according to the Anatomical Therapeutic Chemical classification of the World Health Organization. Data were tabulated in Microsoft Excel® and statistical analysis was performed in the Statistical Package for the Social Sciences®, version 21.0. Results: A total of 488 medical records were included, 53.3% of the patients were male, 60.5% were elderly, with a mean age of 63.17 (SD ± 16.95) and systemic arterial hypertension (67.0%). Regarding the care provided, 66.2% used invasive mechanical ventilation and the most prescribed medications were antibiotics (94.7%), such as azithromycin (71.5%), andcorticosteroids (90.6%). Conclusion: It is concluded that there was a hig her prevalence of elderly patients and those with comorbidities as populations atrisk for severe forms of COVID-19, in addition to the high frequency of use o fthe drug azithromycin.
References
ABU-RUB LI, et al. Antibioticsprescribing in intensivecare settings duringthe COVID-19 era: a systematic review. Antibiotics, 2021; 10: 935.
BAHIA. In: Secretaria Da Saúde Do Estado Da Bahia. Hospital Geral Prado Valadares. Bahia. Disponível em: https ://www.saude.ba.gov.br/hospital/hospital-geral-prado-valadares/. Acesso em: 31 out. 2023.
BARDI T, et al. Nosocomial infectionsassociatedto COVID-19 in the intensive care unit: clinical characteristics and outcome. European Journal of Clinical Microbiology & Infectious Diseases, 2021; 40: 495-502.
BRASIL. Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Diário Oficial da União. 13 jun 2013. Disponível em: https ://www.gov.br/conselho-nacional-de-saude/pt-br/acesso-a-informacao/legislacao/resolucoes/2012/resolucao-no-466.pdf/view. Acessado em: 31 de agosto de 2023.
BRASIL. Orientações do Ministério da Saúde para manuseio medicamentoso precoce de pacientes com diagnóstico da Covid-19. 2020a. Disponível em: https ://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/estudos-e-notas-informativas/2020/old-file-removed-covid-05mar2021-11h37.pdf. Acessado em: 31 de agosto de 2023.
BRASIL. Orientações para manejo de pacientes com COVID-19. 2020b. Disponível em: https ://www.gov.br/saude/pt-br/assuntos/covid-19/publicacoes-tecnicas/recomendacoes/orientacoes-para-manejo-de-pacientes-com-covid-19/view. Acessado em: 31 de agosto de 2023.
BRASIL. Orientações sobre a otimização do uso de oxigênio e suporte ventilatório em pacientes graves com covid-19. 2021. Disponível em: https ://www.gov.br/saude/pt-br/assuntos/covid-19/publicacoes-tecnicas/recomendacoes/orientacoes-sobre-otimizacao-do-uso-de-oxigenio-e-suporte-ventilatorio-em-pacientes-graves-com-covid-19. Acessado em: 10 de maio de 2024.
BUFFON MR, et al. Criticallyill COVID-19 patients: a sociodemographic and clinical profile and associations between variables and work load. Revista Brasileira de Enfermagem, 2022; 75: 20210119.
CARNEIRO GO, et al. Análise das prescrições de pacientes com covid-19 em uso de hidroxicloroquina em uma unidade de terapia intensiva. Revista Ciência Plural, 2023; 9: 1-19.
CHUA EX, et al. Effectofprone versus supine position in COVID-19 patients: A systematic review and meta-analysis. Journal of Clinical Anesthesia, 2021; 74: 110406.
COSTA GS, et al. Impacto da posição prona na clínica de pacientes com COVID-19 e o papel da enfermagem. Revista Eletrônica Acervo Saúde, 2024; 24(12): 17236.
COSTENARO RR, et al. Caracterização dos pacientes internados em uti-covid com evolução a óbito. Arquivos de Ciências da Saúde da UNIPAR, 2023; 27: 2942-2959.
DONATO M, et al. Consensus for the management of analgesia, sedationand delirium in adultswith COVID-19-associated acute respiratory distress syndrome. Revista Brasileira de Terapia Intensiva, 2021; 33: 48-67.
DURÃES RR, et al. Perfil clínico dos pacientes internados por Covid-19 na unidade de terapia intensiva. Journalof Health & Biological Sciences, 2023; 11: 1-5.
FALAVIGNA M, et al. Diretrizes para o tratamento farmacológico da COVID-19. Consenso da Associação de Medicina Intensiva Brasileira, da Sociedade Brasileira de Infectologia e da Sociedade Brasileira de Pneumologia e Tisiologia. Revista Brasileira de Terapia Intensiva, 2020; 32: 166-196.
GALLO A, et al. How can biology of aging explain the severity of COVID-19 in older adults. Clinics in Geriatric Medicine, 2022; 38(3): 461-472.
GAO Y, et al. Risk factors for severe and critical lyill COVID‐19 patients: a review. Allergy, 2021; 76: 428-455.
GHANEI M, et al. The efficacy of corticosteroids therapy in patients with moderate to severe SARS-CoV-2 infection: a multicenter, randomized, open-labeltrial. RespiratoryResearch, 2021; 22: 1-14.
HAJJAR LA, et al. Intensivecare management ofpatientswith COVID-19: a practical approach. Annals of Intensive Care, 2021; 11: 1-17.
IBGE. 2022. Instituto Brasileiro de Geografia e Estatística. Panorama do Censo 2022. Disponível em: https ://censo2022.ibge.gov.br/panorama/. Acesso em: 20 mai. 2024.
RECOVERY COLLABORATIVE GROUP. Dexamethasone in hospitalized patients with Covid-19. New England Journal of Medicine, 2021; 384: 693-704.
RIBEIRO AC, UEHARA SCSA. Systemic arterial hypertension as a riskfactor for the severe form of covid-19: scoping review. Revista de saude publica, 2022; 56: 20.
ROSA MESQUITA R, et al. Clinical manifestations of COVID-19 in the general population: systematic review. Wiener klinische Wochenschrift, 2021; 133: 377-382.
SANTOS HLPC, et al. Gastos públicos com internações hospitalares para tratamento da covid-19 no Brasil em 2020. Revista de saúde pública, 2021; 55: 52.
SONG Z, et al. Hospital pharmacists’ Pharmaceutical care for hospitalized patients with COVID-19: recommendations and guidance from clinical experience. Research in Social and Administrative Pharmacy, 2021; 17(1): 2027-2031.
VIDAL-CORTÉS P, et al. Recomendaciones para el manejo de los pacientes críticos con COVID-19 enlas Unidades de Cuidados Intensivos. Medicina intensiva, 2022; 46(2): 81-89.
WANG R, et al. On-ward participation of clinical pharmacists in a Chinese intensive care unit for patients with COVID-19: A retrospective, observation al study. Research in Social and Administrative Pharmacy, 2021; 17(1): 1853-1858.
WHO. COLLABORATING CENTER FOR DRUG STATISTICS METHODOLOGY. ATC/DDD Index 2024. Disponível em: https ://atcddd.fhi.no/atc_ddd_index/. Acessado em: 31 de outubro de 2023.
WHO. WORLD HEALTH ORGANIZATION. Coronavirus disease (COVID-19) pandemic. 2024. Disponível em: https ://www.who.int/emergencies/diseases/novel-coronavirus-2019. Acessado em: 20 de maio de 2024.
WHO. WORLD HEALTH ORGANIZATION. Corona virus disease (COVID-19). 2023a. Disponível em: https ://www.who.int/news-room/fact-sheets/detail/coronavirus-disease-(covid-19). Acessado em: 24 de maio de 2024.
WHO. WORLD HEALTH ORGANIZATION. Coronavirus disease 2019 (COVID-19): situation report, 51. 2020. Disponível em: https ://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf. Acessado em: 31 de outubro de 2023.
WHO. WORLD HEALTH ORGANIZATION. Therapeutics and COVID-19: Living guideline. 2023b, 198p. Disponível em: https ://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2023.2. Acessado em: 31 de agosto de 2023.
XU J, et al. Clinical characteristics and out comes of patients with severe COVID-19 induced acute kidney injury. Journal of Intensive Care Medicine, 2021; 36(3): 319-326.
ZHU N, et al. A novel coronavírus from patients with pneumonia in China, 2019. New England jornal of medicine, 2020; 382(8): 727-733.
