Fatores comportamentais e de saúde no prognóstico da Síndrome Respiratória Aguda Grave (SRAG)

Abstract

Introduction: Severe Acute Respiratory Syndrome (SARS) is a viral pneumonia that rapidly progresses to respiratory failure. The main agents are the SARS-Cov, MERS-Cov and SARS Cov-2 coronaviruses. To optimize the management of this disease, it is important to understand the relationship between modifiable risk factors and the severity of hospitalization for SARS. Thus, this study aimed to investigate the relationship between behavioral factors, such as smoking, alcohol consumption and obesity with the prognosis of patients hospitalized for SARS in the context of the COVID-19 pandemic. Methodology: A retrospective cohort study was carried out based on the analysis of hospital records of patients at Hospital de Clínicas de Passo Fundo, RS, hospitalized for SARS between January and July 2020. Data collection was carried out between April 2021 and July 2022. The absolute and relative frequencies of the variables of interest were calculated and two-tailed tests were considered significant, whose chi-square test has values of p<0.05. The main exposures analyzed were: current and former smoking, current and former alcoholism and obesity. The dependent variables that characterize the prognosis were use of renal replacement therapy (RRT), orotracheal intubation (OTI), use of ventilatory support (UVS), intensive care unit (ICU) stay, ICU length of stay, and the final outcome. case, was defined as death or discharge. Results: During this period, the medical records of 377 patients were included, most of them men (53.5%), aged ≥60 years (51.2%) and white ethnicity (91.3%). The prevalence of smoking, alcoholism and obesity were, respectively, 12.7%, 4.2% and 9.0%. The use of RRT was more prevalent in current alcoholic patients (25.0%; p=0.013) and obese (23.5%; p=0.001). OTI was higher in ex-smokers (38.0%; p=0.003) and in obese patients (38.2%; p=0.028). And ICU admission was higher in non-obese patients (62.7%; p=0.016). Conclusion: Obesity was the factor associated with more complications during hospitalization for SARS. Current alcoholic patients were more predisposed to use RRT. And smoking history was more relevant for OTI than current smoking among patients in the study sample.