Clinical characteristics of COVID-19 patients and the main nursing diagnoses

1 Institute of Medical Assistance to Public Servants of the State of São Paulo -IAMSPE/SP, Health Sciences Research and Postgraduate, São Paulo, SP, Brazil. 2 University of São Paulo, Medical School FMUSP, São Paulo, SP, Brazil. 3 Faculty of Biomedical Sciences of Cacoal (FACIMED), Department of Nursing, Cacoal, RO, Brazil. 4 Federal Institute of Education, Science and Technology of Rondônia (IFRO), Cacoal, RO, Brazil. Laurindo Pereira de Souza1 orcid.org/0000-0002-9890-2621 laurindosorrisox@hotmail.com

is well established that this virus has a high and sustained transmissibility among people [1,4,5].
Faced with the evolution and spread of the disease around the world, WHO declared worldwide that COVID-19 constitutes a public health emergency of international interest and, for that, immediately adopted measures to control and flatten the disease growth curve around the world. through four strands of the front lines: the first is to prepare and be ready; the second, detect, prevent, and treat; third, reduce and suppress; and the fourth, innovate and improve [3,6].
Nursing professionals are the only ones responsible for direct nursing care to severe and at risk patients, and they are directly in the front line, working every seven days of the week tirelessly, showing that even with limited resources and subhuman conditions in face of the current pandemic the world is living, nursing has been and continues to be fundamental in all four aspects implemented by WHO [6].
Moreover, COVID-19 brought tremendous pressure and disastrous consequences for public health and health systems in Wuhan, as well as in Iran, Italy and other countries [2]. Therefore, when observing the behavior of the pandemic, it was possible to perceive that the virus spreads quickly, due to its high pathogenic power in humans and, although it is still little known, it has shown that the world is united through several researchers who they have, in turn, been looking for solutions that can contain their progress. Thus, it is necessary to rethink the importance of systematizing nursing care as a strategy to reorganize care processes in this pandemic moment.
The systematization of nursing assistance is a scientific methodology that the professional uses to improve nursing care through the survey of problems and clinical judgment, providing greater safety to patients, improving the quality of care and greater autonomy for nursing professionals [7]. It is imperative and private for nurses to systematization of nursing assistance, being organized in five interrelated, interdependent, and recurrent stages, being: I. collection of nursing data, II. nursing diagnosis, III. nursing planning, IV. implementation, V. nursing assessment [7,8].
The implementation and evaluation of nursing actions in addition to the other steps mentioned above seek to identify and resolve the basic social human needs (BSHN) affected by all patients, and in particular, those affected by COVID-19, which is the focus of this research. In this perspective, we recognize the care provided by the BSHN, as guiding elements of the practice of the nursing team and related to nursing care, in its three levels: psychobiological needs, psychosocial needs and psycho-spiritual needs [9].
After identifying health problems, it is necessary to use a taxonomy to implement nursing diagnoses and their interventions. Among the classification systems, the International Classification for Nursing Practice (ICNP © ) stands out, developed by the International Nurses Council, and recognized by WHO as a classification related to the family of classifications. It is configured as a classification system developed to try to supply the need for a universal language within nursing, for the person, family, and community in different places, in order to allow spatial and temporal comparisons [10 -15].

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Historically and today, nurses have always

Methodology
It is a reflection study, which was based on a literature review, in addition to the researchers' perception of the subject addressed. We sought to discuss studies in the field of health sciences involving patients with COVID-19, ranging from moderate to severe signs and symptoms and were assisted in the hospital environment.
In view of the aforementioned statements, the option for this type of study was justified, given that To systematize the extracted information, it was necessary to use a spreadsheet built by the authors in Excel and, thus, judge the compromised BSHN that gave rise to the nursing diagnostic labels.

Results and discussions
In order to better understand the results and discussions of this research, two categories were defined, the first related to presenting studies

Characterization of clinical manifestations of patients with COVID-19
Initial research shows that hypertension, diabetes, and cardiovascular diseases (myocardiopathy and coronary artery disease) were the most frequent comorbidities in affected patients, and with higher mortality rates in these individuals [16][17][18].
Other researchers claim that, in addition to hypertension, other pre-existing diseases, such as chronic lung diseases, addictions such as smoking were part of the previous pathological history of these patients. It is worth noting that most of these comorbidities are related to elderly patients who are more likely to die [1,18].
In view of the clinical manifestations, a recent study [1,17], involving a case series of patients and bilateral pulmonary infiltrate [1,18].
Although COVID-19 is a disease that is still little known about it, it has been observed that its worst complication occurs at the pulmonary level with rapid progression to hypoxemia. In addition, patients may present several clinical outcomes, as revealed in the study [18], such as sepsis, cardiac arrest, Adult Respiratory Distress Syndrome, heart failure, septic shock, coagulopathies, acute kidney injury, acidosis, arrhythmias and other secondary infections such as mechanic ventilation-associated pneumonia.   [20].

Funding
This study did not receive financial support from external sources

Conflicts of interest disclosure
The authors declare no competing interests relevant to the content of this study.

Authors' contributions.
All the authors declare to have made substantial contributions to the conception, or design, or acquisition, or analysis, or interpretation of data; and drafting the work or revising it critically for important intellectual content; and to approve the version to be published.