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Hospital Characteristics Associated With COVID-19 Mortality: Data From the Multicenter Cohort Brazilian COVID-19 Registry

35 Pages Posted: 7 Dec 2021

See all articles by Maíra Viana Rego Souza-Silva

Maíra Viana Rego Souza-Silva

affiliation not provided to SSRN

Patrícia Klarmann Ziegelmann

Universidade Federal do Rio Grande do Sul

Vandack Nobre

affiliation not provided to SSRN

Virginia Mara Reis Gomes

affiliation not provided to SSRN

Ana Paula Beck da Silva Etges

affiliation not provided to SSRN

Alexandre Vargas Schwarzbold

Hospital Universitário de Santa Maria

Aline Gabrielle Sousa Nunes

affiliation not provided to SSRN

Amanda de Oliveira Maurílio

affiliation not provided to SSRN

Ana Luiza Bahia Alves Scotton

affiliation not provided to SSRN

André Soares de Moura Costa

Mater Dei Hospital

Andressa Barreto Glaeser

Hospital Moinhos de Vento

Bárbara Lopes Farace

affiliation not provided to SSRN

Bruno Nunes Ribeiro

affiliation not provided to SSRN

Carolina Marques Ramos

Hospital Júlia Kubitschek

Christiane Corrêa Rodrigues Cimini

Federal University of the Valleys of Jequitinhonha and Mucuri - Mucuri Medical School

Cíntia Alcantara de Carvalho

affiliation not provided to SSRN

Claudete Rempel

affiliation not provided to SSRN

Daniel Vitório Silveira

affiliation not provided to SSRN

Daniela dos Reis Carazai

affiliation not provided to SSRN

Daniela Ponce

São Paulo State University (UNESP) - Department of Internal Medicine

Elayne Crestani Pereira

Hospital SOS Cárdio

Emanuele Marianne Souza Kroger

Hospital Júlia Kubitschek

Euler Roberto Fernandes Manenti

affiliation not provided to SSRN

Evelin Paola de Almeida Cenci

affiliation not provided to SSRN

Fernanda Barbosa Lucas

affiliation not provided to SSRN

Fernanda Costa dos Santos

affiliation not provided to SSRN

Fernando Anschau

Hospital Nossa Senhora da Conceição

Fernando Antonio Botoni

Hospital Júlia Kubitschek

Fernando Graça Aranha

Hospital SOS Cárdio

Filipe Carrilho de Aguiar

affiliation not provided to SSRN

Frederico Bartolazzi

affiliation not provided to SSRN

Gabriela Petry Crestani

Hospital Mãe de Deus

Giovanna Grunewald Vietta

Hospital SOS Cárdio

Guilherme Fagundes Nascimento

affiliation not provided to SSRN

Helena Carolina Noal

affiliation not provided to SSRN

Helena Duani

affiliation not provided to SSRN

Heloisa Reniers Vianna

affiliation not provided to SSRN

Henrique Cerqueira Guimarães

affiliation not provided to SSRN

Joice Coutinho de Alvarenga

affiliation not provided to SSRN

José Miguel Chatkin

affiliation not provided to SSRN

Júlia Drumond Parreiras de Morais

affiliation not provided to SSRN

Juliana da Silva Nogueira Carvalho

affiliation not provided to SSRN

Juliana Machado Rugolo

affiliation not provided to SSRN

Karen Brasil Ruschel

affiliation not provided to SSRN

Lara de Barros Wanderley Gomes

affiliation not provided to SSRN

Leonardo Seixas de Oliveira

Hospital Santa Rosalia

Liege Barella Zandoná

affiliation not provided to SSRN

Lilian Santos Pinheiro

affiliation not provided to SSRN

Liliane Souto Pacheco

affiliation not provided to SSRN

Luanna da Silva Monteiro

affiliation not provided to SSRN

Lucas de Deus Sousa

affiliation not provided to SSRN

Luis Cesar Souto de Moura

affiliation not provided to SSRN

Luisa Elem Almeida Santos

affiliation not provided to SSRN

Luiz Antonio Nasi

Hospital Moinhos de Vento

Máderson Alvares de Souza Cabral

affiliation not provided to SSRN

Maiara Anschau Floriani

Hospital Moinhos de Vento

Maira Dias Souza

affiliation not provided to SSRN

Marcelo Carneiro

Caja Petrolera de Salud - Hospital Santa Cruz

Mariana Frizzo de Godoy

affiliation not provided to SSRN

Marilia Mastrocolla de Almeida Cardoso

affiliation not provided to SSRN

Matheus Carvalho Alves Nogueira

Mater Dei Hospital

Mauro Oscar Soares de Souza Lima

affiliation not provided to SSRN

Meire Pereira de Figueiredo

affiliation not provided to SSRN

Milton Henriques Guimarães Júnior

affiliation not provided to SSRN

Natália da Cunha Severino Sampaio

affiliation not provided to SSRN

Neimy Ramos de Oliveira

Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) - Hospital Eduardo de Menezes (HEM)

Pedro Guido Soares Andrade

Hospital Semper

Pedro Ledic Assaf

affiliation not provided to SSRN

Petrônio José de Lima Martelli

affiliation not provided to SSRN

Raphael Castro Martins

affiliation not provided to SSRN

Reginaldo Aparecido Valacio

affiliation not provided to SSRN

Roberta Pozza

affiliation not provided to SSRN

Rochele Mosmann Menezes

Caja Petrolera de Salud - Hospital Santa Cruz

Rodolfo Lucas Silva Mourato

affiliation not provided to SSRN

Roger Mendes de Abreu

affiliation not provided to SSRN

Rufino de Freitas Silva

affiliation not provided to SSRN

Saionara Cristina Francisco

Hospital Semper

Silvana Mangeon Mereilles Guimarães

Hospital Semper

Silvia Ferreira Araújo

Hospital Semper

Talita Fischer Oliveira

affiliation not provided to SSRN

Tatiana Kurtz

Caja Petrolera de Salud - Hospital Santa Cruz

Tatiani Oliveira Fereguetti

affiliation not provided to SSRN

Thainara Conceição de Oliveira

affiliation not provided to SSRN

Yara Cristina Neves Marques Barbosa Ribeiro

affiliation not provided to SSRN

Yuri Carlotto Ramires

affiliation not provided to SSRN

Carísi Anne Polanczyk

Universidade Federal do Rio Grande do Sul

Milena Soriano Marcolino

Federal University of Minas Gerais (UFMG) - Department of Internal Medicine

More...

Abstract

Background:The COVID-19 pandemic caused unprecedented pressure over health care systems, but hospital-level data that may influence the prognosis are not well-studied. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with mortality in COVID-19 patients admitted to Brazilian institutions.

Methods:This is a multicenter retrospective cohort. Patients with COVID-19 admitted from March to September 2020, were enrolled. Data were collected through hospital records, forms, and open databases. Generalized linear mixed models with logit link function were used to assess association between hospital characteristics and mortality. Two models were built, one testing hospital general characteristics and another testing ICU factors. All analysis were adjusted for the proportion of high-risk patients at admission.

Findings:Thirty-one hospitals were included. Mortality ranged from 9·0% to 48·0%. In the first model, hospitals with private funding (β=-0·37; 95%CI: -0·71 to -0·04; p=0·029) and in municipalities with high gross domestic product (GDP) per capita (β=-0·40; 95%CI: -0·72 to -0·08; p=0·014) were independently associated with lower mortality. The second model included 23 hospitals and showed that ICUs with a work shift composed of less than 10% of medical residents (β=-0·40; 95%CI: -0·68 to -0·11; p=0.006) and those with more than 50% of intensivists (β=-0·59; 95%CI: -0·98 to -0·20; p=0·003) were independently associated with lower mortality.

Interpretation: Funding, city-level GDP and the experience of the critical care medical team were independently associated with COVID-19 in-hospital mortality.

Funding Information: Minas Gerais State Agency for Research and Development (FAPEMIG), Institute for Health Technology Assessment (IATS/CNPq) and CAPES Foundation.

Declaration of Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics Approval Statement: This study followed the STROBE guidelines for reporting observational studies, and it is in accordance with the Declaration of Helsinki. The study protocol was approved by the Brazilian National Commission for Research Ethics (CAAE: 30350820·5·1001·0008). Individual informed consent was waived due to the severity of the pandemic situation and the use of deidentified data, based on medical chart review only.

Keywords: COVID-19, healthcare, hospital, intensive care, mortality.

Suggested Citation

Souza-Silva, Maíra Viana Rego and Klarmann Ziegelmann, Patrícia and Nobre, Vandack and Mara Reis Gomes, Virginia and da Silva Etges, Ana Paula Beck and Schwarzbold, Alexandre Vargas and Sousa Nunes, Aline Gabrielle and de Oliveira Maurílio, Amanda and Bahia Alves Scotton, Ana Luiza and Soares de Moura Costa, André and Barreto Glaeser, Andressa and Farace, Bárbara Lopes and Ribeiro, Bruno Nunes and Ramos, Carolina Marques and Cimini, Christiane Corrêa Rodrigues and Carvalho, Cíntia Alcantara de and Rempel, Claudete and Vitório Silveira, Daniel and dos Reis Carazai, Daniela and Ponce, Daniela and Pereira, Elayne Crestani and Kroger, Emanuele Marianne Souza and Manenti, Euler Roberto Fernandes and Cenci, Evelin Paola de Almeida and Lucas, Fernanda Barbosa and dos Santos, Fernanda Costa and Anschau, Fernando and Botoni, Fernando Antonio and Aranha, Fernando Graça and de Aguiar, Filipe Carrilho and Bartolazzi, Frederico and Crestani, Gabriela Petry and Vietta, Giovanna Grunewald and Nascimento, Guilherme Fagundes and Noal, Helena Carolina and Duani, Helena and Vianna, Heloisa Reniers and Guimarães, Henrique Cerqueira and Alvarenga, Joice Coutinho de and Chatkin, José Miguel and Drumond Parreiras de Morais, Júlia and Carvalho, Juliana da Silva Nogueira and Machado Rugolo, Juliana and Ruschel, Karen Brasil and de Barros Wanderley Gomes, Lara and Seixas de Oliveira, Leonardo and Barella Zandoná, Liege and Santos Pinheiro, Lilian and Souto Pacheco, Liliane and da Silva Monteiro, Luanna and de Deus Sousa, Lucas and Cesar Souto de Moura, Luis and Elem Almeida Santos, Luisa and Antonio Nasi, Luiz and Alvares de Souza Cabral, Máderson and Floriani, Maiara Anschau and Dias Souza, Maira and Carneiro, Marcelo and Frizzo de Godoy, Mariana and Mastrocolla de Almeida Cardoso, Marilia and Nogueira, Matheus Carvalho Alves and Oscar Soares de Souza Lima, Mauro and Pereira de Figueiredo, Meire and Guimarães Júnior, Milton Henriques and da Cunha Severino Sampaio, Natália and Ramos de Oliveira, Neimy and Guido Soares Andrade, Pedro and Ledic Assaf, Pedro and José de Lima Martelli, Petrônio and Castro Martins, Raphael and Aparecido Valacio, Reginaldo and Pozza, Roberta and Mosmann Menezes, Rochele and Mourato, Rodolfo Lucas Silva and Mendes de Abreu, Roger and de Freitas Silva, Rufino and Francisco, Saionara Cristina and Guimarães, Silvana Mangeon Mereilles and Ferreira Araújo, Silvia and Fischer Oliveira, Talita and Kurtz, Tatiana and Fereguetti, Tatiani Oliveira and Conceição de Oliveira, Thainara and Cristina Neves Marques Barbosa Ribeiro, Yara and Carlotto Ramires, Yuri and Polanczyk, Carísi Anne and Marcolino, Milena Soriano, Hospital Characteristics Associated With COVID-19 Mortality: Data From the Multicenter Cohort Brazilian COVID-19 Registry. Available at SSRN: https://ssrn.com/abstract=3979651 or http://dx.doi.org/10.2139/ssrn.3979651

Maíra Viana Rego Souza-Silva (Contact Author)

affiliation not provided to SSRN

No Address Available

Patrícia Klarmann Ziegelmann

Universidade Federal do Rio Grande do Sul ( email )

Rua Washington Luiz #855
Porto Alegre, 90010460
Brazil

Vandack Nobre

affiliation not provided to SSRN ( email )

No Address Available

Virginia Mara Reis Gomes

affiliation not provided to SSRN ( email )

No Address Available

Ana Paula Beck Da Silva Etges

affiliation not provided to SSRN

No Address Available

Alexandre Vargas Schwarzbold

Hospital Universitário de Santa Maria ( email )

Santa Maria
Brazil

Aline Gabrielle Sousa Nunes

affiliation not provided to SSRN ( email )

No Address Available

Amanda De Oliveira Maurílio

affiliation not provided to SSRN ( email )

No Address Available

Ana Luiza Bahia Alves Scotton

affiliation not provided to SSRN ( email )

No Address Available

André Soares de Moura Costa

Mater Dei Hospital ( email )

15, Palazzo Castellania
Merchants Street
Valletta, VLT 1171
Malta

Andressa Barreto Glaeser

Hospital Moinhos de Vento ( email )

Porto Alegre
Brazil

Bárbara Lopes Farace

affiliation not provided to SSRN

No Address Available

Bruno Nunes Ribeiro

affiliation not provided to SSRN ( email )

No Address Available

Carolina Marques Ramos

Hospital Júlia Kubitschek ( email )

Belo Horizonte
Brazil

Christiane Corrêa Rodrigues Cimini

Federal University of the Valleys of Jequitinhonha and Mucuri - Mucuri Medical School ( email )

Teófilo Otoni
Brazil

Cíntia Alcantara de Carvalho

affiliation not provided to SSRN ( email )

No Address Available

Claudete Rempel

affiliation not provided to SSRN ( email )

No Address Available

Daniel Vitório Silveira

affiliation not provided to SSRN ( email )

No Address Available

Daniela Dos Reis Carazai

affiliation not provided to SSRN ( email )

No Address Available

Daniela Ponce

São Paulo State University (UNESP) - Department of Internal Medicine ( email )

Sao Paulo
Brazil

Elayne Crestani Pereira

Hospital SOS Cárdio ( email )

Florianópolis
Brazil

Emanuele Marianne Souza Kroger

Hospital Júlia Kubitschek ( email )

Belo Horizonte
Brazil

Euler Roberto Fernandes Manenti

affiliation not provided to SSRN ( email )

No Address Available

Evelin Paola de Almeida Cenci

affiliation not provided to SSRN ( email )

No Address Available

Fernanda Barbosa Lucas

affiliation not provided to SSRN ( email )

No Address Available

Fernanda Costa Dos Santos

affiliation not provided to SSRN ( email )

No Address Available

Fernando Anschau

Hospital Nossa Senhora da Conceição ( email )

Porto Alegre
Brazil

Fernando Antonio Botoni

Hospital Júlia Kubitschek ( email )

Belo Horizonte
Brazil

Fernando Graça Aranha

Hospital SOS Cárdio ( email )

Florianópolis
Brazil

Filipe Carrilho De Aguiar

affiliation not provided to SSRN ( email )

No Address Available

Frederico Bartolazzi

affiliation not provided to SSRN ( email )

No Address Available

Gabriela Petry Crestani

Hospital Mãe de Deus ( email )

Porto Alegre
Brazil

Giovanna Grunewald Vietta

Hospital SOS Cárdio ( email )

Florianópolis
Brazil

Guilherme Fagundes Nascimento

affiliation not provided to SSRN

No Address Available

Helena Carolina Noal

affiliation not provided to SSRN ( email )

No Address Available

Helena Duani

affiliation not provided to SSRN

No Address Available

Heloisa Reniers Vianna

affiliation not provided to SSRN ( email )

No Address Available

Henrique Cerqueira Guimarães

affiliation not provided to SSRN ( email )

No Address Available

Joice Coutinho de Alvarenga

affiliation not provided to SSRN ( email )

No Address Available

José Miguel Chatkin

affiliation not provided to SSRN

No Address Available

Júlia Drumond Parreiras de Morais

affiliation not provided to SSRN ( email )

No Address Available

Juliana da Silva Nogueira Carvalho

affiliation not provided to SSRN ( email )

No Address Available

Juliana Machado Rugolo

affiliation not provided to SSRN ( email )

No Address Available

Karen Brasil Ruschel

affiliation not provided to SSRN

No Address Available

Lara De Barros Wanderley Gomes

affiliation not provided to SSRN ( email )

No Address Available

Leonardo Seixas de Oliveira

Hospital Santa Rosalia ( email )

Teófilo Otoni
Brazil

Liege Barella Zandoná

affiliation not provided to SSRN ( email )

No Address Available

Lilian Santos Pinheiro

affiliation not provided to SSRN ( email )

No Address Available

Liliane Souto Pacheco

affiliation not provided to SSRN ( email )

No Address Available

Luanna Da Silva Monteiro

affiliation not provided to SSRN

No Address Available

Lucas De Deus Sousa

affiliation not provided to SSRN ( email )

No Address Available

Luis Cesar Souto de Moura

affiliation not provided to SSRN ( email )

No Address Available

Luisa Elem Almeida Santos

affiliation not provided to SSRN ( email )

No Address Available

Luiz Antonio Nasi

Hospital Moinhos de Vento ( email )

Porto Alegre
Brazil

Máderson Alvares de Souza Cabral

affiliation not provided to SSRN ( email )

No Address Available

Maiara Anschau Floriani

Hospital Moinhos de Vento

Porto Alegre
Brazil

Maira Dias Souza

affiliation not provided to SSRN ( email )

No Address Available

Marcelo Carneiro

Caja Petrolera de Salud - Hospital Santa Cruz ( email )

Santa Cruz de la Sierra
Bolivia

Mariana Frizzo de Godoy

affiliation not provided to SSRN ( email )

No Address Available

Marilia Mastrocolla de Almeida Cardoso

affiliation not provided to SSRN ( email )

No Address Available

Matheus Carvalho Alves Nogueira

Mater Dei Hospital

15, Palazzo Castellania
Merchants Street
Valletta, VLT 1171
Malta

Mauro Oscar Soares de Souza Lima

affiliation not provided to SSRN ( email )

No Address Available

Meire Pereira de Figueiredo

affiliation not provided to SSRN ( email )

No Address Available

Milton Henriques Guimarães Júnior

affiliation not provided to SSRN

No Address Available

Natália Da Cunha Severino Sampaio

affiliation not provided to SSRN ( email )

No Address Available

Neimy Ramos de Oliveira

Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) - Hospital Eduardo de Menezes (HEM) ( email )

Belo Horizonte
Brazil

Pedro Guido Soares Andrade

Hospital Semper ( email )

Belo Horizonte
Brazil

Pedro Ledic Assaf

affiliation not provided to SSRN ( email )

No Address Available

Petrônio José de Lima Martelli

affiliation not provided to SSRN ( email )

No Address Available

Raphael Castro Martins

affiliation not provided to SSRN ( email )

No Address Available

Reginaldo Aparecido Valacio

affiliation not provided to SSRN ( email )

No Address Available

Roberta Pozza

affiliation not provided to SSRN ( email )

No Address Available

Rochele Mosmann Menezes

Caja Petrolera de Salud - Hospital Santa Cruz ( email )

Santa Cruz de la Sierra
Bolivia

Rodolfo Lucas Silva Mourato

affiliation not provided to SSRN

No Address Available

Roger Mendes de Abreu

affiliation not provided to SSRN ( email )

No Address Available

Rufino De Freitas Silva

affiliation not provided to SSRN ( email )

No Address Available

Saionara Cristina Francisco

Hospital Semper

Silvana Mangeon Mereilles Guimarães

Hospital Semper

Belo Horizonte
Brazil

Silvia Ferreira Araújo

Hospital Semper ( email )

Belo Horizonte
Brazil

Talita Fischer Oliveira

affiliation not provided to SSRN ( email )

No Address Available

Tatiana Kurtz

Caja Petrolera de Salud - Hospital Santa Cruz ( email )

Santa Cruz de la Sierra
Bolivia

Tatiani Oliveira Fereguetti

affiliation not provided to SSRN

No Address Available

Thainara Conceição de Oliveira

affiliation not provided to SSRN ( email )

No Address Available

Yara Cristina Neves Marques Barbosa Ribeiro

affiliation not provided to SSRN ( email )

No Address Available

Yuri Carlotto Ramires

affiliation not provided to SSRN ( email )

No Address Available

Carísi Anne Polanczyk

Universidade Federal do Rio Grande do Sul ( email )

Milena Soriano Marcolino

Federal University of Minas Gerais (UFMG) - Department of Internal Medicine ( email )

Porto Alegre
Brazil

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