Banca de QUALIFICAÇÃO: ALINE CARRILHO MENEZES

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : ALINE CARRILHO MENEZES
DATE: 27/09/2023
TIME: 14:00
LOCAL: Videoconferência
TITLE:

CLINICAL AND EVOLUTIONARY CHARACTERISTICS OF PATIENTS WITH COVID-19 UNDER MONITORING BY THE SERVICE TELEASSISTANCE AND TELEMONITORING OF THE MUNICIPALITY OF DIVINÓPOLIS, MINAS GERAIS


KEY WORDS:
COVID-19. Severe Acute Respiratory Syndrome. Natural History of Diseases. Epidemiology. Telemedicine. Telemonitoring.

PAGES: 115
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:
Objective: to describe the main clinical characteristics and factors associated with the
occurrence of complications and hospitalizations of patients treated and monitored by
a Telecare and Telemonitoring Service for suspected cases of COVID-19
(TeleCOVID). Method: cross-sectional study carried out with secondary data analysis.
The sample was obtained through electronic records of adult patients with suspected
COVID-19 respiratory conditions, treated by TeleCOVID in the city of Divinópolis,
Minas Gerais, between May 2020 and December 2021. The explanatory variables
(sociodemographic and clinical) were obtained from the electronic medical records of
patients treated at TeleCOVID and hospital admission record information from the
Influenza Epidemiological Surveillance Information System (SIVEP-Gripe- Sistema de
Informação da Vigilância Epidemiológica da Gripe in Portuguese) database. The two
databases were joined by convergence using the linkage method, using the Individual
Taxpayer Registry (ITR) number as a linking variable. The variables analyzed were:
sex; age; presence of signs of severity; presence of symptoms; presence of
comorbidities; testing for COVID-19; test result; referral to a Basic Health Unit (BHU)
or Emergency Care Unit (ECU); and self-reported hospital admission due to COVID-
19. The association between the explanatory variables and each outcome of interest
(hospitalization; need for referral for in-person assessment) was assessed by
estimating the Odds Ratio (OR), with a 95% confidence interval (95% CI). For this
purpose, bivariate analysis was initially carried out using contingency tables with Chi
square calculation. Next, multivariate analysis was performed using Multiple Logistic
Regression. The significance level adopted in analyzes was 0.05. The fit of the final
model was assessed using the Hosmer-Lemeshow test. Partial results: 8325 patients
were treated at TeleCOVID, 63.1% of whom were female, aged between 18 and 39
years. Around a quarter had some comorbidity, 10.5% of patients had some warningsign. Of the total, 169 (2.0%) patients were admitted to a hospital and 44 (0.5%) died.
The final logistic regression model showed that the factors independently associated
with hospital admission were: being male (OR: 1.89, 95%CI 1.36-2.61); being between
40 and 59 years old (OR: 4.11, 95%CI 2.66-6.33) or 60 or more years old (OR:14.18,
95%CI 8.93- 22.53); having a diagnosis of other risk comorbidities (chronic renal
failure, chromosomal disease, rheumatological, oncological or post-transplant
immunosuppressive disease) (OR: 2.54, 95% CI 1.41-4.57); and having a fever (OR:
2.16, 95%CI 1.56-3.00); cough (OR: 1.87, 95%CI 1.28-2.74); myalgia (OR: 3.04, 95%
CI 2.19-4.21) or coryza (OR: 1.94, 95% CI 1.39-2.70). Conclusion: the results showed
that TeleCOVID contributed to tackling the pandemic, providing remote assistance with
high resolution. The establishment of criteria for eligibility for remote assistance must
be defined, considering the need for in-person evaluation and monitoring, especially
for elderly patients and those with pre-existing risk comorbidities presenting acute flu
like symptoms. Therefore, recognizing vulnerable populations can guide the
development of monitoring strategies that prevent the disease from worsening.

BANKING MEMBERS:
Presidente - 1715700 - CLARECI DA SILVA CARDOSO
Interno - 1716637 - TARCISIO LAERTE GONTIJO
Externa à Instituição - CLARA RODRIGUES ALVES DE OLIVEIRA - UFMG
Notícia cadastrada em: 15/09/2023 15:58
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