Gravidade da COVID-19 e relação com sequelas em pacientes após internação hospitalar

Abstract

ntroduction: : Post-COVID-19 syndrome is characterized by a set of symptoms that emerge during or after COVID-19 infection, persist for more than 12 weeks, and cannot be fully explained by other diagnoses. Objective: To assess the relationship between disease severity and the presence of sequelae up to 12 months after hospital discharge in individuals who were hospitalized due to COVID-19. Method: A cross-sectional study was conducted in Passo Fundo/RS with individuals who were hospitalized between September 2021 and September 2022. The sample was systematically selected from hospitalization records obtained from Epidemiological Surveillance. Individuals with a confirmed COVID-19 diagnosis, aged 18 years or older, who were discharged from the hospital and resided in Passo Fundo were included. Data were collected through home interviews conducted from July 2022 to April 2023, lasting approximately 50 to 60 minutes. The evaluation considered disease severity, classified based on ICU admission, length of hospitalization, and use of mechanical ventilation. Independent variables included gender, age, race, marital status, education level, smoking, vaccination, comorbidities, and the number of sequelae, which was considered significant when the participant reported 10 or more symptoms. The prevalence of outcomes was calculated with a 95% confidence interval (CI95) and analyzed according to independent variables, using the chi-square test with a 5% type I error. Results: The sample comprised 149 individuals, most of whom were women (52.3%) and elderly (67.8% were 60 years or older). Self-perceived health was rated as poor by 69.1% of participants, and 77.2% had received at least two doses of the COVID-19 vaccine. The most common comorbidities were hypertension (59.1%) and heart disease (38.3%). The prevalence of severe COVID-19 cases was 55.7%, and the prevalence of sequelae up to 12 months after discharge was 54% (CI95: 46-62). There was no statistically significant relationship between disease severity and the presence of 10 or more sequelae (p>0.005). However, significant relationships were identified between variables used as severity criteria and the development of sequelae, with emphasis on the length of hospitalization, use of mechanical ventilation, and disease severity. A significant association was observed between difficulty in performing daily activities and the length of hospitalization (62.7%, p=0.013), mechanical ventilation (60%, p=0.017), and disease severity (62.7%, p=0.014). Conclusion: Patients who developed severe cases of COVID-19 had a higher prevalence of sequelae up to 12 months after hospital discharge. These findings highlight the need to implement rehabilitation strategies focused on improving the quality of life of post COVID-19 patients.