RESUMO
This study applied causal criteria in directed acyclic graphs for handling covariates in associations for prognosis of severe coronavirus disease 2019 (COVID-19) cases. To identify non-specific blood tests and risk factors as predictors of hospitalisation due to COVID-19, one has to exclude noisy predictors by comparing the concordance statistics (area under the curve - AUC) for positive and negative cases of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Predictors with significant AUC at negative stratum should be either controlled for their confounders or eliminated (when confounders are unavailable). Models were classified according to the difference of AUC between strata. The framework was applied to an open database with 5644 patients from Hospital Israelita Albert Einstein in Brazil with SARS-CoV-2 reverse transcription - polymerase chain reaction (RT-PCR) exam. C-reactive protein (CRP) was a noisy predictor: hospitalisation could have happened due to causes other than COVID-19 even when SARS-CoV-2 RT-PCR is positive and CRP is reactive, as most cases are asymptomatic to mild. Candidates of characteristic response from moderate-to-severe inflammation of COVID-19 were: combinations of eosinophils, monocytes and neutrophils, with age as risk factor; and creatinine, as risk factor, sharpens the odds ratio of the model with monocytes, neutrophils and age.
Assuntos
COVID-19/diagnóstico , Testes Hematológicos , COVID-19/sangue , COVID-19/complicações , COVID-19/epidemiologia , Testes Hematológicos/métodos , Testes Hematológicos/normas , Hospitalização , Humanos , Prognóstico , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Objetivo: evidenciar quais são as repercussões no leito vascular e as características dos neonatos de gestantes com Síndromes Hipertensivas Gestacionais e/ou Diabetes Mellitus Gestacional. Método: trata-se de uma revisão sistemática de literatura, as buscas da pesquisa foram realizadas no mês de julho do ano de 2017, nas bases de dados da Literatura Latino-Americana do Caribe em Ciências da Saúde e na National Library of Medicine. Os dados foram tabulados em planilhas do Excel, sendo aplicada a análise de conteúdo. Resultados: os recém-nascidos de mães hipertensas estiveram relacionados a prematuridade e baixo peso para a idade gestacional, enquanto os recém-nascidos de mães diabéticas são relacionados a uma maior idade gestacional ao nascimento e peso considerado grande para a idade gestacional. Considerações finais: salienta-se a importância do acompanhamento através do pré-natal desde os primórdios da gestação, como medida protetiva à saúde materno-infantil.
Objective: investigate the repercussions in the vascular bed and the characteristics of the neonates of pregnant women with Hypertensive Syndromes in Pregnancy and/or Gestational Diabetes Mellitus. Methods: it is a systematic review of the literature, the research searches were carried out in July of the year 2017, in the databases of Latin American Literature of the Caribbean in Health Sciences and National Library of Medicine. Data were tabulated in Excel spreadsheets, and content analysis was applied. Results: newborns of hypertensive mothers were related to prematurity and low birth weight for gestational age, while the newborns of diabetic mothers are related to a higher gestational age at birth and a heaviest for gestational age. Final considerations: importance of follow-up through prenatal care from the earliest stages of gestation, as a protective measure for maternal and child health.