Prevalence and factors associated with the death of older people hospitalized due to Covid-19 in the state of Paraná.
Luiz Hiroshi Inoue, Wanessa Cristina Baccon, Giovanna Brichi Pesce and 6 others
PMID 38265117WHAT IT FOUND
Among 35,580 older people hospitalized with severe Covid-19 in Brazil, 45% died.
Risk was highest for those aged 85+, men, and those needing ventilatory support. Flu vaccination was linked to an 11% lower likelihood of death. Heart disease and severe symptoms were not significant after adjustment.
Key findings
01Of 35,580 older people hospitalized with severe acute respiratory syndrome due to Covid-19, 16,153 died during hospitalization.
02In the adjusted analysis, flu vaccination was associated with an 11% lower likelihood of death, and use of ventilatory support was associated with a probability of death 2.6 times higher.
03After adjusting for other variables, heart disease and symptom severity lost statistical significance as independent factors associated with death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relied on secondary administrative data, which may contain underreporting or incomplete information. Missing data for variables like flu vaccination and comorbidities were treated as 'non-occurrence' of the event, which may introduce bias if records were simply not filled due to workload. The sample was restricted to hospitalized patients, meaning the results may overestimate the association between factors and death compared to the general population of older adults with Covid-19. The study design is cross-sectional, so it identifies associations rather than proving that one factor caused another.
Declared interests
The work was funded by Brazilian government agencies including CAPES, CNPq, FNDCT, and the Ministry of Health. No commercial conflicts of interest were declared.
The easy way to misread this
Do not interpret the lower death rate in flu-vaccinated patients as proof that the vaccine directly prevents death from SARS-CoV-2. This is an observational study, so the association may reflect that vaccinated people are generally healthier or have better access to care, rather than a direct causal effect of the flu shot on Covid-19 mortality.