Resumen
Objetivo: Analizar el perfil clínico-epidemiológico de pacientes internados con COVID-19 en un hospital de urgencia. Métodos: Se trata de un estudio individuado, observacional, transversal, con muestra de conveniencia. Se analizó la presencia de diabetes, mortalidad por grupo de edad, necesidad de internación en Unidad de Terapia Intensiva (UTI), mortalidad por tiempo de internación en la UTI, necesidad de Intubación Orotraqueal (IOT), mortalidad por días de IOT, necesidad de Drogas Vasoativas (DVA). Resultados: Pacientes diabéticos presentaron mayor tasa de admisión en UTI (76,8%) que los no diabéticos (NDM) (56%), mayor necesidad de IOT (39,5%) en relación a los NDM (33,4%), mayor necesidad de DVA (42%) que los NDM (34,41%). Además, los pacientes diabéticos presentaron peores resultados después de la admisión en la UCI. Se verificó que la cantidad de glicemias alteradas durante la internación está directamente relacionada a la mayor admisión en camas de UTI, necesidad de IOT y óbito. Conclusión: Se concluye que la presencia de diabetes y el mal control glucémico antes y durante la internación están relacionados a peores resultados.
Referencias
ALMEIDA KC, et al. Prevalência e correlação das comorbidades por idade e sexo dos óbitos por COVID-19 no estado de Sergipe-Brasil: parte I. Revista eletrônica Acervo Saúde, 2020; 12(11): 4806.
ARONS MM, et al. Presympomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. The New England Journal of Medicine, 2020; 382(22): 2081-2090.
AZEVEDO MCA, et al. Relação fisiopatológica entre covid e diabetes melitus tipo 2: uma revisão narrativa. Revista Acervo Saúde, 2022; 15(4): 10154.
BARROS HM, et al. Perfil epidemiológico e correlação entre comorbidades com o tempo de internação, desfecho e necessidade de ventilação invasiva em indivíduos com COVID-19 em um hospital de referência do estado do Pará, Brasil. Revista eletrônica Acervo Saúde, 2022; 15(8): 10825.
CARIOU B, et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO. Study Diabetologia, 2020; 63(8): 1500-1515.
CLEMENT S, et al. Management of diabetes and hyperglicemia in hospitals. Diabetes Care, 2004; 27(2): 553-591.
GALICIA-GARCIA U, et al. Pathophysiology of type 2 diabetes mellitus. International Journal of Molecular Sciences, 2020; 21(17): 6275.
HARTMANN-BOYCE J, et al. Risks of and from sars-cov-2 infection and COVID-19 in people with diabetes: a systematic review of reviews. Diabetes Care. American Diabetes Association, 2021; 44(12): 2790–2811.
HUANG C, et al. Clinical features of patients infected with 2019 novel coronavirus in wuhan, china. The Lancet, 2020; 395(10223): 497-506.
HUSSAIN A, et al. COVID-19 and diabetes: Knowledge in progress. Diabetes Research and Clinical Practice, 2020; 162: 108142.
INZUCCHI SE, et al. 2023. Management of diabetes mellitus in hospitalized patients. Disponível em: https ://www.Up-to-date.Com/contents/management-of-diabetes-mellitus-in-hospitalized-patients. Acessado em 10 de dezembro de 2023.
LEE S, et al. Clinical course and molecular viral shedding among asymptomatic and symptomatic patients with SARS-CoV-2 infection in a comunity treatment center in the Republic of Korea. JAMA internal medicine, 2020; 180(11): 1447-1452.
MUNIYAPPA R e GUBBI S. COVID-19 pandemic, coronaviruses, and diabetes mellitus. American Journal of Physiology - Endocrinology and Metabolism, 2020; 318(5): 736-741.
ORAN DP e TOPOL EJ. The proportion of SARS-CoV-2 infections that are asymptomatic: a systematyc review. Annals of internal medicine, 2021; 174(5): 655-662.
REN H, et al. Association of the insulin resistance marker TyG index with the severity and mortality of COVID-19. Cardiovascular diabetology, 2020; 19(1): 58.
RICHARDSON S, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA internal medicine, 2020; 323(20): 2052-2059.
TARGHER G, et al. Patients with diabetes are at higher risk for severe illness from COVID-19. Diabetes & metabolismo, 2020; 46(4): 335-337.
TURCHIN A, et al. Hypoglicemia and clinical outcomesin patients with diabetes hospitalized in the general ward, 2009; 32(7): 1153-1157.
WORLD HEALTH ORGANIZATION. 2020. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. Disponível em: https ://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. Acessado em 15 de abril de 2024.
WU L, et al. COVID-19 and diabetes: Insulin requirements parallel illness severity in critically unwell patients. Clinical endocrinology (Oxford), 2020; 93(4): 390-393.
WU Z e MCGOOGAN JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA internal medicine, 2020; 323(13): 1239-1242.
