Author:

• Mellina Marques Vieira Izecksohn - Izecksohn, M.M.V - <mellizeck@gmail.com>
ORCID: https://orcid.org/0000-0001-7767-9478

Co-author(s):

• Iuri da Costa Leite - Leite, I.C - <iuri.fiocruz@gmail.com>
ORCID: https://orcid.org/0000-0002-9136-8948
• Regina Paiva Daumas - Daumas, R.P - <regina.daumas@gmail.com>
ORCID: https://orcid.org/0000-0002-8923-7711
• Rosane Esteves Siqueira Rodrigues - Rodrigues, R.E.S - <rosane.siqueira@fiocruz.br>
ORCID: https://orcid.org/0009-0008-8911-2207

Abstract:

This retrospective cohort study investigated factors associated with Severe Acute Respiratory Syndrome (SARS) or death among confirmed COVID-19 cases treated at a Primary Health Care unit in Rio de Janeiro,August 2020 to January 2022. The occurrence of SARS or death was identified in the Systems of Information of Epidemiological Surveillance of Influenza and Mortality Information, respectively. Individual characteristics, symptoms, and predominant viral variant were the explanatory variables tested in logistic regression models. Out of 1,708 COVID-19 episodes, 72 (4.2%) resulted in SARS, of which 17 (1.0%) were fatal. Among the risk factors for SARS, obesity (OR: 19.7; 95% CI: 7.5-52.8), pregnancy (OR: 16.8; 95% CI: 1.8-111.2), chronic heart disease (OR: 6.6; 95% CI: 1.1-28.4), diabetes (OR: 2.8; 95% CI: 1.3-5.9), dyspnea (OR: 7.0; 95% CI: 3.6-13.6), fever (OR: 2.4; 95% CI: 1.3-4.4), and illness during the predominance of the Gamma variant were highlighted. There were no cases of worsening during the predominance of the Omicron variant. It is concluded that the risk of COVID-19 worsening depends on individual patient characteristics as well as the circulating viral variants, emphasizing the essential role of continuous surveillance in identifying changes in the epidemiological landscape and guiding prevention and care strategies.

Keywords:

COVID-19, Prognosis, Primary Health Care

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