Características clínicas associadas ao agravamento da Covid-19 e na predisposição ao desenvolvimento da Condição Pós-Covid

Abstract

Brazil has recorded approximately 37 million cases of COVID-19 as of January 2023. Beyond the acute manifestations, COVID-19 might progress to a chronic disease, known as Post-COVID Condition (PCC). This study describes the clinical profile of a cohort of patients infected with SARS-CoV-2 in 2020 and investigates health implications and quality of life two years after infection. In 2020, 704 patients diagnosed with COVID-19 were enlisted from hospitals and through social media postings. Male sex and diabetes during the acute infection displayed higher risks for disease severity (RR=1.76; 95%CI: 1.43 – 2.17 and RR=1.60; 95%CI: 1.28 – 2.00). The use of "COVID Kit" medications— antimalarials, azithromycin, and ivermectin—was significantly higher in severe and critical severity groups (p=0.010, p<0.001, p=0.010, respectively), but no significant impact on patient survival was observed. A total of 105 patients died due to COVID-19 and its complications. Between May and June 2022, 137 surviving individuals were surveyed concerning PCC symptoms. Persistent symptoms were reported by 56.9% of patients, with 70% still experiencing these symptoms two years post-infection. Women and individuals hospitalized during the acute infection phase faced a higher risk of experiencing symptoms after COVID-19 (RR=2.07; 95%CI: 1.47 – 2.94 and RR=1.53; 95%CI: 1.07 – 2.18). Respiratory disturbances, neurological effects, and body pains were the most frequently reported manifestations. At least 20% of individuals reported some degree of difficulty in performing daily activities. We identified that risk factors such as male gender and the presence of comorbidities were associated with COVID-19 severity, while the risk of developing PCC was linked to female gender, hospitalization during the acute phase, and the first SARS-CoV-2 infection. Vaccination against COVID-19 did not demonstrate an effect on the progression of PCC symptoms. In this context, our study is crucial in providing an overview of the Brazilian situation and guiding further studies, as well as the development of public policies aimed at addressing PCC.