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Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID‐19 in Brazil: a surveillance database analysis

Takemoto, MLS ; Menezes, MO ; Andreucci, CB ; Knobel, R ; Sousa, L ; Katz, L ; Fonseca, EB ; Nakamura‐Pereira, M ; Magalhães, CG ; Diniz, CSG ; Melo, ASO ; Amorim, MMR

BJOG : an international journal of obstetrics and gynaecology, 2020-12, Vol.127 (13), p.1618-1626 [Periódico revisado por pares]

England: Wiley Subscription Services, Inc

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Título:
Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID‐19 in Brazil: a surveillance database analysis
Autor: Takemoto, MLS ; Menezes, MO ; Andreucci, CB ; Knobel, R ; Sousa, L ; Katz, L ; Fonseca, EB ; Nakamura‐Pereira, M ; Magalhães, CG ; Diniz, CSG ; Melo, ASO ; Amorim, MMR
Assuntos: Adult ; Betacoronavirus ; Brazil ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Comorbidity ; Coronavirus Infections - mortality ; Coronavirus Infections - therapy ; COVID-19 ; Critical Care ; Cross-Sectional Studies ; Databases, Factual ; Demography ; Diabetes mellitus ; Diabetes Mellitus - epidemiology ; Epidemiology ; Ethnic Groups - statistics & numerical data ; Fatalities ; Female ; health services accessibility ; health status indicators ; Humans ; Logistic Models ; maternal death ; Maternal mortality ; Mortality ; Multivariate Analysis ; Obesity, Maternal - epidemiology ; Obstetrics ; Pandemics ; Pneumonia, Viral - mortality ; Pneumonia, Viral - therapy ; Population ; Postpartum ; Pregnancy ; Pregnancy Complications, Cardiovascular - epidemiology ; Pregnancy Complications, Infectious - mortality ; Pregnancy Complications, Infectious - therapy ; Puerperal Disorders - mortality ; Puerperal Disorders - therapy ; Respiration, Artificial ; Respiratory distress syndrome ; Respiratory Distress Syndrome - mortality ; Respiratory Distress Syndrome - therapy ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; Surveillance ; Ventilation ; Womens health ; Young Adult
É parte de: BJOG : an international journal of obstetrics and gynaecology, 2020-12, Vol.127 (13), p.1618-1626
Notas: https://doi.org/10.1111/1471-0528.16521
This article is commented on by NT Joseph and BJWylie, p. 1627 in this issue. To view this mini commentary visit
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Linked article: This article is commented on by NT Joseph and BJWylie, p. 1627 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16521
Descrição: Objective To describe clinical characteristics of pregnant and postpartum women with severe COVID‐19 in Brazil and to examine risk factors for mortality. Design Cross‐sectional study based on secondary surveillance database analysis. Setting Nationwide Brazil. Population or sample 978 Brazilian pregnant and postpartum women notified as COVID‐19 Acute Respiratory Distress Syndrome (ARDS) cases with complete outcome (death or cure) up to 18 June 2020. Methods Data was ed from the Brazilian ARDS Surveillance System (ARDS‐SS) database. All eligible cases were included. Data on demographics, clinical characteristics, intensive care resources use and outcomes were collected. Risk factors for mortality were examined by multivariate logistic regression. Main outcome measures Case fatality rate. Results We identified 124 maternal deaths, corresponding to a case fatality rate among COVID‐19 ARDS cases in the obstetric population of 12.7%. At least one comorbidity was present in 48.4% of fatal cases compared with 24.9% in survival cases. Among women who died, 58.9% were admitted to ICU, 53.2% had invasive ventilation and 29.0% had no respiratory support. The multivariate logistic regression showed that the main risk factors for maternal death by COVID‐19 were being postpartum at onset of ARDS, obesity, diabetes and cardiovascular disease, whereas white ethnicity had a protective effect. Conclusions Negative outcomes of COVID‐19 in this population are affected by clinical characteristics but social determinants of health also seem to play a role. It is urgent to reinforce containment measures targeting the obstetric population and ensure high quality care throughout pregnancy and the postpartum period. Tweetable A total of 124 COVID‐19 maternal deaths were identified in Brazil. Symptoms onset at postpartum and comorbidities are risk factors. Tweetable A total of 124 COVID‐19 maternal deaths were identified in Brazil. Symptoms onset at postpartum and comorbidities are risk factors.
Editor: England: Wiley Subscription Services, Inc
Idioma: Inglês

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Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID‐19 in Brazil: a surveillance database analysis

Takemoto, MLS ; Menezes, MO ; Andreucci, CB ; Knobel, R ; Sousa, L ; Katz, L ; Fonseca, EB ; Nakamura‐Pereira, M ; Magalhães, CG ; Diniz, CSG ; Melo, ASO ; Amorim, MMR

England: Wiley Subscription Services, Inc

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