Factors Associated with the Occurrence of Severe Acute Respiratory Syndrome (SARS) among COVID-19 Cases

Abstract This retrospective cohort study investigated factors associated with Severe Acute Respiratory Syndrome (SARS) or death among confirmed COVID-19 cases treated at a Primary Health Care (PHC) unit in Rio de Janeiro from August 2020 to January 2022. The occurrence of SARS or death was identified in the Influenza Epidemiological Surveillance Information System and in the Mortality Information System, respectively. Individual characteristics, symptoms, and predominant viral variant were the explanatory variables tested in logistic regression models. Of 1,708 COVID-19 episodes, 72 (4.2%) resulted in SARS, of which 17 (1.0%) were fatal. Among the risk factors for SARS, obesity, pregnancy, chronic heart disease, diabetes, dyspnea, fever, and illness during the predominance of the Gamma variant were highlighted. There were no cases of worsening during the predominance of the Omicron variant. In conclusion, the risk of COVID-19 worsening depends on individual patient characteristics as well as the circulating viral variants, underscoring the essential role of continuous surveillance in detecting changes in the epidemiological landscape and in guiding prevention and care strategies.