scholarly journals Neopterin predicts disease severity in hospitalized patients with COVID-19

2020 ◽  
Author(s):  
Rosa Bellmann-Weiler ◽  
Lukas Lanser ◽  
Francesco Burkert ◽  
Stefanie Seiwald ◽  
Gernot Fritsche ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Analysis ◽  
Disease Severity ◽  
Predictive Value ◽  
Clinical Management ◽  
Inflammatory Markers ◽  
Predictive Marker ◽  
Hospitalized Patients ◽  
Icu Admission ◽  
Circulating Inflammatory Markers

Abstract This study evaluates the predictive value of circulating inflammatory markers, especially neopterin, in patients with COVID-19. Within this retrospective analysis of 115 hospitalized COVID-19 patients, elevated neopterin levels upon admission were significantly associated with disease severity, risk for ICU admission, need for mechanical ventilation and death. Therefore, neopterin is a reliable predictive marker in patients with COVID-19 and may help to improve the clinical management of patients.

scholarly journals Assessment and Modeling of COVID-19 Outcomes in a Longitudinal Cohort of Hospitalized Adults

2021 ◽  
Author(s):  
Lacy M Simons ◽  
Ramon Lorenzo-Redondo ◽  
Meg Gibson ◽  
Sarah L Kinch ◽  
Jacob P Vandervaart ◽  
...  
Keyword(s):  
Viral Load ◽  
Disease Severity ◽  
Antibody Titer ◽  
Neutrophil Count ◽  
Clinical Management ◽  
Lymphocyte Count ◽  
Hospitalized Patients ◽  
Viral Genotype ◽  
Icu Admission ◽  
Over Time

Background: While several demographic and clinical correlates of Coronavirus Disease 2019 (COVID-19) outcome have been identified, they remain imprecise tools for clinical management of disease. Furthermore, there are limited data on how these factors are associated with virological and immunological parameters over time. Methods and Findings: Nasopharyngeal swabs and blood samples were longitudinally collected from a cohort of 58 hospitalized adults with COVID-19 in Chicago, Illinois between March 27 and June 9, 2020. Samples were assessed for SARS-CoV-2 viral load, viral genotype, viral diversity, and antibody titer. Demographic and clinical information, including patient blood tests and several composite measures of disease severity, were extracted from electronic health records. All parameters were assessed for association with three patient outcome groups: discharge without intensive care unit (ICU) admission (n = 23), discharge with ICU admission (n = 29), and COVID-19 related death (n = 6). Higher age, male sex, and higher body mass index (BMI) were significantly associated with ICU admission. At hospital admission, higher 4C Mortality scores and lactate dehydrogenase (LDH) levels were likewise associated with ICU admission. Longitudinal trends in Deterioration Index (DI) score, Modified Early Warning Score (MEWS), and serum neutrophil count were also associated with ICU admission, though only the retrospectively calculated median DI score was predictive of death. While viral load and genotype were not significantly associated with outcome in this study, viral load did correlate positively with C-reactive protein levels and negatively with D-dimer, lymphocyte count, and antibody titer. Intra-host viral genetic diversity resulted in changes in viral genotype in some participants over time, though intra-host evolution was not associated with outcome. A stepwise-generated multivariable model including BMI, lymphocyte count at admission, and neutrophil count at admission was sufficient to predict outcome with a 0.82 accuracy rate in this cohort. Conclusions: These studies suggest that COVID-19 disease severity and poor outcomes among hospitalized patients are likely driven by dysfunctional host responses to infection and underlying co-morbid conditions rather than SARS-CoV-2 viral loads. Several parameters, including 4C mortality score, LDH levels, and DI score, were ultimately predictive of participant outcome and warrant further exploration in larger cohort studies for use in clinical management and risk assessment. Finally, the prevalence of intra-host diversity and viral evolution in hospitalized patients suggests a mechanism for population-level change, further emphasizing the need for effective antivirals to suppress viral replication and to avoid the emergence of new variants.

scholarly journals Safety, tolerability, and outcomes of losartan use in patients hospitalized with SARS-CoV-2 infection: A feasibility study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244708
Author(s):  
Olena Bolotova ◽  
Jeanwoo Yoo ◽  
Imran Chaudhri ◽  
Luis A. Marcos ◽  
Haseena Sahib ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Feasibility Study ◽  
Prospective Cohort ◽  
Inflammatory Markers ◽  
Retrospective Cohort ◽  
Randomized Clinical Trials ◽  
Hospitalized Patients ◽  
Nasopharyngeal Swab ◽  
Exclusion Criteria ◽  
Icu Admission

Background Retrospective studies on the use of Renin-Angiotensin-Aldosterone System blockade in patients with Coronavirus Disease 2019 (COVID-19) have been informative but conflicting, and prospective studies are required to demonstrate the safety, tolerability, and outcomes of initiating these agents in hospitalized patients with COVID-19 and hypertension. Methods and findings This is a single center feasibility study encompassing two cohorts: (1) prospective cohort (April 21, 2020 to May 29, 2020) and (2) retrospective cohort (March 7, 2020 to April 1, 2020) of hospitalized patients with real-time polymerase chain reaction (PCR) positive SARS-CoV-2 by nasopharyngeal swab. Key inclusion criteria include BP > 130/80 and a requirement of supplemental oxygen with FiO2 of 25% or higher to maintain SpO2 > 92%. Key exclusion criteria included hyperkalemia and acute kidney injury (AKI) at the time of enrollment. Prospective cohort consisted of de novo initiation of losartan and continuation for a minimum of 7 days and assessed for adverse events (AKI, hyperkalemia, transaminitis, hypotension) and clinical outcomes (change in SpO2/FiO2 and inflammatory markers, need for ICU admission and mechanical ventilation). Retrospective cohort consisted of continuation of losartan (prior-to-hospitalization) and assessment of similar outcomes. In the prospective cohort, a total of 250 hospitalized patients were screened and inclusion/exclusion criteria were met in 16/250 patients and in the retrospective cohort, a total of 317 hospitalized patients were screened and inclusion/exclusion criteria were met in 14/317 patients. Most common adverse event was hypotension, leading to discontinuation in 3/16 (19%) and 2/14 (14%) patients in the prospective and retrospective cohort. No patients developed AKI in the prospective cohort as compared to 1/14 (7%) patients in the retrospective cohort, requiring discontinuation of losartan. Hyperkalemia occurred in 1/16 (6%) and 0/14 patients in the prospective and retrospective cohorts, respectively. In the prospective cohort, 3/16 (19%) and 2/16 (13%) patients required ICU admission and mechanical ventilation. In comparison, 3/14 (21%) required ICU admission and mechanical ventilation in the retrospective cohort. A majority of patients in both cohorts (14/16 (88%) and 13/14 (93%) patients from the prospective and retrospective cohort) were discharged alive from the hospital. A total of 9/16 (prospective) and 5/14 (retrospective) patients completed a minimum 7 days of losartan. In these 9 patients in the prospective cohort, a significant improvement in SpO2/FiO2 ratio was observed from day 1 to 7. No significant changes in inflammatory markers (initiation, peak, and day 7) were observed in either cohort. Conclusion In this pilot study we demonstrate that losartan was well-tolerated among hospitalized patients with COVID-19 and hypertension. We also demonstrate the feasibility of patient recruitment and the appropriate parameters to assess the outcomes and safety of losartan initiation or continuation, which provides a framework for future randomized clinical trials.

scholarly journals Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110277
Author(s):  
Tyler Pitre ◽  
Angela (Hong Tian) Dong ◽  
Aaron Jones ◽  
Jessica Kapralik ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Icu Admission

Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

Lung Ultrasound to Monitor Disease Severity and Aid Prognostication in COVID-19 Pneumonia: A Retrospective Analysis of Serial Lung Ultrasound Assessments

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 109-116
Author(s):  
Matthew Llewelyn Gibbins ◽  
Quentin Otto ◽  
Paul Adrian Clarke ◽  
Stefan Gurney
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Analysis ◽  
Disease Severity ◽  
Scoring System ◽  
Lung Ultrasound ◽  
Weaning From Mechanical Ventilation ◽  
Icu Discharge ◽  
Successful Weaning ◽  
Ultrasound Assessment ◽  
Disease Free

Background: The aim of this retrospective analysis was to assess if serial lung ultrasound assessments in patients with COVID-19 pneumonia, including a novel simplified scoring system, correlate with PaO2:FiO2 ratio, as a marker of disease severity, and patient outcomes. Methods: Patients treated for COVID-19 pneumonia in a tertiary intensive care unit who had a lung ultrasound assessment were included. Standardised assessments of anterior and lateral lung regions were prospectively recorded. A validated lung ultrasound score-of-aeration and a simplified scoring system based on the number of disease-free lung regions were correlated with: PaO2:FiO2 ratio,  successful weaning from mechanical ventilation, and status (alive or dead) at discharge.  MedCalc© statistical software was used for statistical analysis. Results: 28 patients (109 assessments) were included. Correlation was seen between score-of-aeration and PaO2:FiO2 ratio (r = -0.61, p<0.0001) and between the simplified scoring system and PaO2:FiO2 ratio (r = 0.52 p<0.0001). Achieving a score-of-aeration of ≤9/24 or ≥2 disease-free regions was associated with successful weaning from mechanical ventilation and survival to ICU discharge (accuracy of 94% and 97% respectively). Conclusion: Retrospective analysis from this small cohort of patients demonstrates that scores-of-aeration and a simplified scoring system based on the number of disease-free antero-lateral regions from serial LUS assessments correlate with PaO2:FiO2 ratio as a marker of disease severity in patients with COVID-19 pneumonia. In addition, lung ultrasound may help identify patients who will have favourable outcomes. 

scholarly journals TRENDS IN MECHANICAL VENTILATION AND MORTALITY IN HOSPITALIZED PATIENTS WITH COVID-19: A RETROSPECTIVE ANALYSIS

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1127
Author(s):  
Abigail Watts ◽  
Efstathia Polychronopoulou ◽  
Daniel Puebla Neira
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Analysis ◽  
Hospitalized Patients

scholarly journals The Potential Role of Therapeutic Dose of Low Molecular Weight Heparin (LWMH) to Attenuate Hyper-Inflammatory State in Hospitalized COVID-19 Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 11-12
Author(s):  
Mohsin Sheraz Mughal ◽  
Ikwinder Preet Kaur ◽  
Ali R. Jaffery ◽  
Chang Wang ◽  
Muhammad Asif ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Disease Severity ◽  
Inflammatory Markers ◽  
Potential Role ◽  
Hospitalized Patients ◽  
Inflammatory State ◽  
Anti Inflammatory ◽  
D Dimer ◽  
Inflammatory Effect

Introduction:The underlying pathophysiology of severe COVID-19 involves cytokine storm syndrome that is associated with an elevation of immunoinflammatory cytokines [1]. This hyper-inflammatory state has been implicated with coagulopathy among severely sick patients with COVID-19. Inflammation and coagulopathy are interlinked processes [2]. Coagulopathy has been associated with high mortality in COVID-19 patients [3]. LMWH is traditionally used for its anticoagulant and antithrombotic properties, however, its anti-inflammatory effect has not been fully elucidated. A study done by Shastri et al. suggested that LMWH can inhibit the release of different cytokines (IL-4, IL-5, IL-13, and TNF-α) [4]. Recent retrospective studies on COVID-19 illustrated that the LMWH (40-60 mg, subcutaneously every day) was associated with better prognosis as measured by (28 days of survival) in severely sick patients meeting sepsis-induced coagulopathy (SIC≥4) criteria compared to nonusers [5]. The potential role of escalated/therapeutic LMWH (1mg/kg/subcutaneously every 12 hours) remains unclear. This study involves a retrospective analysis of the potential role of an escalated dose of LMWH to alter the hyper-inflammatory state in hospitalized patients with COVID-19 and compared outcomes to those patients who received a low dose (40-60 mg, subcutaneously every day) of LMWH. Methods:Adult patients with confirmed SARS-CoV-2 infection by nasopharyngeal (NP) polymerase chain reaction (PCR) who were hospitalized from March 1st to April 20, 2020, were included. They were divided into two cohorts based on the dose of LMWH; cohort 1 (40-60 mg, subcutaneously every day) and cohort 2 (1mg/kg/subcutaneously every 12 hours). Categorical variables were compared by conducting a chi-square test or Fisher's exact test while continuous ones were compared by conducting a median two-sample test. Results:The median values of PT, PTT, INR, CRPmax, LDHmax, ferritinmax, D-dimermax, are mentioned in table 1. Incidence of thrombotic events (deep venous thrombosis, ischemic stroke, pulmonary embolism) was higher in cohort 1 (n=3, 4.8%) compared to cohort 2 (n=1, 2.6%). Cohort 2 had a higher number of patients who received ICU level of care (n=24) compared to the 6 patients in cohort 1. Out of 24 patients in cohort 2, 18 patients received invasive mechanical ventilation. The median value of length of stay in the hospital (10.0 days) and all-cause mortality (31.6 %) were higher in cohort 2 as compared to cohort 1 (p&lt;0.05). Discussion:Infections have the ability to trigger systemic inflammation [6]. The interplay between the host system and its response to foreign pathogens can lead to the activation of coagulation pathways. SARS-CoV-2 entry via ACE-2 receptors on endothelial cells is likely associated with endothelial dysfunction. This endotheliopathy plays a significant role in COVID-19 related microcirculatory changes [7]. Severe COVID-19, a hyperinflammatory state, is marked by elevated inflammatory markers including D-dimer, ferritin, IL-6, LDH, and CRP levels. Elevated D-dimer levels have been correlated with disease severity and poor outcomes in hospitalized patients with COVID-19 [8]. The incidence of VTE and pulmonary embolism among COVID-19 ICU patients was higher in a study from France [9]. The patient population who received the escalated dose of LMWH in our study either had SIC score ≥ 4 or D-dimer ≥ 2.2 (FEU). This data indicated that the median value of peak inflammatory markers in cohort 1 was lower (p&lt;0.05) when compared to cohort 2. Patients in cohort 2 were sicker than cohort 1, as evidenced by a statistically significant longer length of hospital stay and a higher rate of ICU admission. However, the potential dose-dependent anti-inflammatory effect of LMWH was not observed. Additional studies evaluating comorbidities and disease severity in both cohorts may yield different results. Conclusion:Aside from the known anticoagulant benefit of LMWH, there was no additional anti-inflammatory role with higher doses (1mg/kg/subcutaneously every 12 hours) of LMWH. Disclosures No relevant conflicts of interest to declare.

scholarly journals Diabetes mellitus as a risk factor for poor early outcomes in patients hospitalized with COVID-19

2020 ◽  
Author(s):  
Jacqueline Seiglie ◽  
Jesse Platt ◽  
Sara Jane Cromer ◽  
Bridget Bunda ◽  
Andrea S. Foulkes ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Risk Factor ◽  
Regression Models ◽  
Massachusetts General Hospital ◽  
Hospitalized Patients ◽  
Patient Centered ◽  
Logistic Regression Models ◽  
Icu Admission

<b>OBJECTIVE</b> <p>Diabetes mellitus and obesity are highly prevalent among hospitalized patients with COVID-19, but little is known about their contributions to early COVID-19 outcomes. We tested the hypothesis that diabetes is a risk factor for poor early outcomes, after adjustment for obesity, among a cohort of patients hospitalized with COVID-19. <b></b></p> <p><b> </b></p> <p><b>RESEARCH DESIGN AND METHODS </b>We used data from the Massachusetts General Hospital (MGH) COVID-19 Data Registry of patients hospitalized with COVID-19 between March 11, 2020 and April 30, 2020. Primary outcomes were admission to the intensive care unit (ICU), need for mechanical ventilation, and death within 14 days of presentation to care. Logistic regression models were adjusted for demographic characteristics, obesity, and relevant comorbidities. </p> <p> </p> <p><b>RESULTS</b></p> <p>Among 450 patients, 178 (39.6%) had diabetes, mostly type 2 diabetes. A higher proportion of patients with diabetes were admitted to the ICU (42.1% vs. 29.8%, p=0.007), required mechanical ventilation (37.1% vs. 23.2%, p=0.001), and died (15.9% vs. 7.9%, p=0.009), compared with patients without diabetes. In multivariable logistic regression models, diabetes was associated with greater odds of ICU admission (OR 1.59 [95% CI 1.01-2.52]), mechanical ventilation (1.97 [1.21-3.20]), and death (2.02 [1.01-4.03]) at 14-days. Obesity was associated with higher odds of ICU admission (2.16 [1.20-3.88]) and mechanical ventilation (2.13 [1.14-4.00]) but not with death. </p> <p> </p> <p><b>CONCLUSIONS</b></p> <p>Among hospitalized patients with COVID-19, diabetes was associated with poor early outcomes, after adjusting for obesity. These findings can help inform patient-centered care decision making for people with diabetes at risk of COVID-19.</p>

scholarly journals 392. Predictors of Mortality in Hospitalized Patients with COVID-19; A Single Centered Retrospective Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S265-S266
Author(s):  
Farah N Harmouch ◽  
Kashyap Shah ◽  
Harsh Goel
Keyword(s):  
Logistic Regression ◽  
Multivariate Analysis ◽  
Retrospective Analysis ◽  
Inflammatory Markers ◽  
Clinical Characteristics ◽  
Conditional Logistic Regression ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Categorical Variables ◽  
Predictors Of Mortality

Abstract Background The Coronavirus disease-2019 (COVID-19) has been responsible for the death of over 400,000 people with a continuous rise in prevalence and mortality globally. Identifying hospitalized patients at high mortality risk is critical for triage and health-care resource management regionally, nationally, and globally. We present a retrospective analysis of predictors of mortality in hospitalized COVID-19 patients. Methods Electronic health records (EHR) of patients admitted between March 1 and April 18, 2020 to St. Luke’s University Hospital with a primary diagnosis of COVID-19 were reviewed for medical co-morbidities and initial biochemical/inflammatory markers. Survivors vs non-survivors were compared using χ 2 test, Student’s t-test, and Mann-Whitney U-test as appropriate. Univariate logistic regression was used to identify candidate variables for multivariate analysis, which were then included in stepwise backward logistic regression. Statistical analyses were done on SPSS v26 software (IBM, Armonk, NY). Results Clinical characteristics, biochemical abnormalities and results of univariate regression in our cohort of 560 patients are noted in table 1. Multivariate regression revealed age, congestive heart failure (CHF), and creatinine≥ 1.5 mg/dl as significant predictors of mortality while race (Caucasian), vascular disease, lymphopenia, and elevated ferritin approached significance (Table 2). Table 1: Baseline clinical characteristics, overall and by mortality. Continuous variables are presented as median (25th-75th percentile), and categorical variables as n (%) Significance of difference between subgroups (survivors versus non-survivors) *p≤0.05, **p≤0.01, ***p≤0.001 Table 2: Results of stepwise backward conditional logistic regression for predicting mortality among hospitalized COVID-19 patients. (n=334, 287 survivors and 47 non-survivors). ALC – Absolute lymphocyte count, S.E. – Standard error of B. Conclusion We present one of the largest cohorts to date of hospitalized COVID-19 patients. Age, CHF, and renal disease were significant independent predictors of mortality. Though several inflammatory markers (d-dimer, CRP, procalcitonin) initially predicted mortality, they failed in multivariate analysis, questioning their role in risk-stratifying COVID-19 hospitalized patients. Interestingly, IL-6 used in those severely ill patients to assess candidacy for IL-6 inhibitor therapy (Tocilizumab) failed to predict mortality in our study. Our analysis was limited due to its retrospective nature and unfortunately large amounts of data were missing for some variables (ESR, BNP, IL-6 levels). The missing data was due to rapidly evolving institutional protocols early during the pandemic, leading to non-uniform assessment of these markers. Disclosures All Authors: No reported disclosures

scholarly journals Tuberculosis in hospitalized patients: clinical characteristics of patients receiving treatment within the first 24 h after admission

2014 ◽  
Vol 40 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Denise Rossato Silva ◽  
Larissa Pozzebon da Silva ◽  
Paulo de Tarso Roth Dalcin
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Admission Rate ◽  
Hospitalized Patients ◽  
Tuberculosis Treatment ◽  
Medical Attention ◽  
Considerable Proportion ◽  
Sputum Smear ◽  
Icu Admission

Objective: To evaluate clinical characteristics and outcomes in patients hospitalized for tuberculosis, comparing those in whom tuberculosis treatment was started within the first 24 h after admission with those who did not. Methods: This was a retrospective cohort study involving new tuberculosis cases in patients aged ≥ 18 years who were hospitalized after seeking treatment in the emergency room. Results: We included 305 hospitalized patients, of whom 67 (22.0%) received tuberculosis treatment within the first 24 h after admission ( ≤24h group) and 238 (88.0%) did not (>24h group). Initiation of tuberculosis treatment within the first 24 h after admission was associated with being female (OR = 1.99; 95% CI: 1.06-3.74; p = 0.032) and with an AFB-positive spontaneous sputum smear (OR = 4.19; 95% CI: 1.94-9.00; p < 0.001). In the ≤24h and >24h groups, respectively, the ICU admission rate was 22.4% and 15.5% (p = 0.258); mechanical ventilation was used in 22.4% and 13.9% (p = 0.133); in-hospital mortality was 22.4% and 14.7% (p = 0.189); and a cure was achieved in 44.8% and 52.5% (p = 0.326). Conclusions: Although tuberculosis treatment was initiated promptly in a considerable proportion of the inpatients evaluated, the rates of in-hospital mortality, ICU admission, and mechanical ventilation use remained high. Strategies for the control of tuberculosis in primary care should consider that patients who seek medical attention at hospitals arrive too late and with advanced disease. It is therefore necessary to implement active surveillance measures in the community for earlier diagnosis and treatment.

Sign in / Sign up

Export Citation Format

Share Document