<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2021000300036</article-id>
<article-id pub-id-type="doi">10.24950/o/135/21/3/2021</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Impacto da Pandemia COVID-19 na Mortalidade em Serviço de Urgência]]></article-title>
<article-title xml:lang="en"><![CDATA[COVID-19 Pandemic&#8217;s Impact on Emergency Department&#8217;s Mortality]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paixão]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[Rita Costa e]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Spilker]]></surname>
<given-names><![CDATA[Ruben]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Rogério]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Lèlita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[Armando de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade de Coimbra Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidade de Coimbra Faculdade de Medicina CIMAGO, Centro de Investigação]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>28</volume>
<numero>3</numero>
<fpage>36</fpage>
<lpage>42</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2021000300036&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2021000300036&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2021000300036&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Dados oficiais revelam que a mortalidade por todas as causas, em Portugal, em 2020 é superior à de 2019. O receio dos doentes de contágio por SARS-CoV-2 condicionou o protelar de avaliações médicas por opção ou imposição e o recurso aos Serviços de Urgência (SU) não foi exceção. O objetivo foi comparar as características demográficas, clínicas e analíticas dos doentes falecidos num SU dedicado à COVID-19, com igual período do ano pregresso.  Material e Métodos:  Estudo retrospetivo, no qual foram analisadas as notas de alta dos doentes que faleceram durante a permanência no SU entre os dias 18 de março e 22 de junho de 2019 e 2020. A análise estatística foi realizada com recurso ao programa IBM SPSS.  Resultados:  Durante o período analisado faleceram no SU 33 doentes no ano de 2019 e 99 doentes em 2020, o que equivale a uma taxa de mortalidade de 0,34% e 1,89%, respetivamente. Destaca-se que, em 2020, apenas 4,04% (n = 4) dos óbitos eram de doentes com zaragatoas SARS-CoV-2 positivas ainda que todos os falecidos apresentassem infeções respiratórias graves. Houve uma diferença estatisticamente significativa no que concerne ao tempo de permanência no SU (p &lt; 0,01), alectuamento (p = 0,04), demência (p = 0,03) e presença de insuficiência respiratória à admissão (p = 0,001). Não se verificaram diferenças no que diz respeito aos dados demográficos, maioria das comorbilidades e parâmetros analíticos.  Conclusão:  Em relação a 2019, os óbitos verificados em 2020 no SU ocorreram em doentes mais vulneráveis e com doença mais grave. Foi a procura mais tardia dos cuidados hospitalares, particularmente na agudização de doenças crónicas, que condicionou, de forma irreversível, este desfecho. O número de mortes passível de ser atribuído à COVID-19 é ínfimo, merecendo reflexão e readaptação de boas práticas que assegurem que os doentes sejam admitidos nos SU dentro das janelas temporais preconizadas e de acordo com as patologias suspeitas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Official data shows increased excess all-cause mortality in 2020 compared to 2019. Fear of expo-sure constrained medical evaluations which were delayed by either choice or imposition. Going to the emergency department (ED) was no exception. Our objective was to compare demographic, clinical and analytical characteristics of pa-tients who died in a COVID-19 dedicated ED with the same period of 2019.  Material and Methods:  Retrospective study analysing patient discharge notes who have died during ED permanence between March 18th and June 22nd of 2019 and in the same period of 2020. Statistical analysis was performed using IBM SPSS software.  Results:  A total of 33 patients died in 2019 whereas 99 died in 2020 during the analysed period, representing a mortality rate of 0.34% and 1.89%, respectively. Only 4.04% (n = 4) of deceased patients tested positive for SARS-CoV-2 in 2020, while all showed severe respiratory infections. There was a statistically significant difference concerning length of stay in ED (p &lt; 0.01), being bedridden (p = 0.04), dementia (p = 0.03) and presence of respiratory failure at admission (p = 0.001). There were no differences regarding demographic data, comorbidities, and other analytical parameters.  Conclusion:  In 2020, deaths in the ED occurred among more vulnerable patients and with more severe disease. It was the later demand for hospital care, particularly in the worsening of chronic diseases, that irreversibly conditioned this outcome, especially in the context of chronic diseases exacerbation. Furthermore, the number of deaths that can be attributed to COVID-19 is negligible, deserving reflection and readaptation of good practices ensuring that patients are admitted to the ED within the recommended time and in accordance with the suspected pathologies.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[Mortalidade]]></kwd>
<kwd lng="pt"><![CDATA[SARS-CoV-2]]></kwd>
<kwd lng="pt"><![CDATA[Serviço de Urgência Hospitalar.]]></kwd>
<kwd lng="en"><![CDATA[COVID-19;Emergency Service, Hospital]]></kwd>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
<kwd lng="en"><![CDATA[SARS-CoV-2.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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