INVESTIGAÇÃO DE FATORES DETERMINANTES DA LETALIDADE ENTRE OS CASOS DE COVID-19 INTERNADOS EM HOSPITAIS DO PARANÁ

Abstract

The world faced one of the biggest health crises in recent history with the COVID-19 pandemic, caused by SARS-CoV-2, a virus with a high contagion capacity, which led to many patients needing hospitalization and intensive care. Objectives: Investigate factors that impacted the difference in lethality between hospitals involved in caring for patients affected by COVID-19 in the state of Paraná, during the years 2020, 2021 and 2022. Methodology: This is an ecological study, based on of notification data on all hospital admissions due to severe acute respiratory syndrome (SARS) caused by COVID-19 in selected hospitals in the 22 Health Regions of Paraná. The mortality rates of hospitals were compared, according to their legal nature, throughout the pandemic waves and the patient‘s clinical data. Results: After comparing the different fatality rates according to the legal nature of the hospitals, significantly greater impacts were observed in public administration and/or non-profit hospitals compared to business entities. Among the possible determining factors to explain these differences, the results suggest an important role for the presence of comorbidities (heart disease, systemic arterial hypertension and diabetes) and clinical presentation with more severe symptoms (dyspnea and low oxygen saturation), which occurred in a greater proportion among patients admitted to public hospitals. Conclusions: It was demonstrated that there is a higher lethality rate in hospitals of a legal nature classified as public, possibly explained by the characteristics of the patients treated by these entities.