Nevin AYDIN, Osman ESEN, Umut KARAYALÇIN

Evaluation of demographic characteristics and laboratory results of patients with Covid-19 treated in the intensive care unit

Background: We aimed to investigate the clinical features, hemodynamic and respiratory profiles as well as prognostic outcomes of critically sick COVID-19 patients admitted to intensive care units (ICUs). Methods: This retrospective study was performed using data derived from 99 adult patients treated in the ICU. Demographic and clinical data as well as hemodynamic and respiratory profiles, theraputic outcomes were recorded. The relationship between these features and ICU stay was sought. Results: The average age was 65.94 ± 14.93 years (24 to 96), and 73 patients (73.7%) had comorbidities. Smokers constituted 13.1% of the Covid-19 patient population (n=13) in ICU. Thirty-one cases (31.3%) had received at least one dose of Covid-19 vaccine and 63 patients (63.6%) died in the ICU after their initial hospitalization. Blood products were utilized in 29 patients (29.3%) and delta mutation was detected in 23 (23.2%) of ICU patients. The mean duration of ICU stay was 16.90 ± 11.41 days (1 to 60). The duration of ICU stay was remarkably different between groups receiving different antibiotic regimens (p<0.001). There was no significant relationship between the duration of ICU stay and blood groups (p=0.052), systolic (p=0.572) and diastolic blood pressure (p=0.098) and initial arterial oxygen saturation (p=0.223). Conclusion: We detected a high mortality rate in our series with severe COVID-19 infection treated in ICU. These data are critical for understanding the impact of COVID-19 on our hospitals, identifying areas for clinical management improvement, and allowing for continuous international and temporal comparisons of COVID-19 patient outcomes.

Keywords:

Covid-19, Treatment, İntensive Care Unit,

PDF

___

Reference1 Alharthy A, Aletreby W, Faqihi F, Balhamar A, Alaklobi F, Alanezi K, et al. Clinical Characteristics and Predictors of 28-Day Mortality in 352 Critically Ill Patients with COVID-19: A Retrospective Study. J Epidemiol Glob Health. 2021; 11: 98-104.
Reference2 Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323; 1574–81.
Reference3 Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J 2020; 55; 2000524.
Reference4 Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al.; LICORN and the Lille COVID-19 and Obesity study group. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring). 2020; 28: 1195-99. Erratum in: Obesity (Silver Spring). 2020; 28: 1994.
Reference5 Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, et al. Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission. Clin Infect Dis. 2020; 71: 896-7.
Reference6 Gattinoni L, Chiumello D, Rossi S. COVID-19 pneumonia: ARDS or not? Crit Care. 2020; 24: 154. Reference7 Vahidy FS, Drews AL, Masud FN, Schwartz RL, Askary BB, Boom ML, et al. Characteristics and Outcomes of COVID-19 Patients During Initial Peak and Resurgence in the Houston Metropolitan Area. JAMA 2020; 324: 998-1000.
Reference8 Krause M, Douin DJ, Kim KK, Fernandez-Bustamante A, Bartels K. Characteristics and Outcomes of Mechanically Ventilated COVID-19 Patients-An Observational Cohort Study. J Intensive Care Med 2021; 36: 271-6. 9. Ñamendys-Silva SA, Alvarado-Ávila PE, Domínguez-Cherit G, Rivero-Sigarroa E, Sánchez-Hurtado LA, Gutiérrez-Villaseñor A, et al.; Mexico COVID-19 Critical Care Collaborative Group. Outcomes of patients with COVID-19 in the intensive care unit in Mexico: A multicenter observational study. Heart Lung. 2021; 50: 28-32.
Reference10 Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; 8: 475-81. Erratum in: Lancet Respir Med. 2020; 8: e26.
Reference11 Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al.; COVID-19 Lombardy ICU Network. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med. 2020; 180: 1345-55. Reference12 Olanipekun T, Abe TA, Effoe VS, Musonge-Effoe JE, Chuks A, Kwara E, et al. Intensive care unit hospitalizations and outcomes in patients with severe COVID-19 during summer and fall surges in Georgia. World J Crit Care Med. 2021; 10: 369-76.
Reference13 Pan A, Liu L, Wang C, Guo H, Hao X, Wang Q, et al. Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China. JAMA. 2020; 323: 1-9.
Reference14 Koo JR, Cook AR, Park M, Sun Y, Sun H, Lim JT, et al. Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study. Lancet Infect Dis. 2020; 20: 678-88.
Reference15 Murthy S, Archambault PM, Atique A, Carrier FM, Cheng MP, Codan C, et al; SPRINT-SARI Canada Investigators and the Canadian Critical Care Trials Group. Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study. CMAJ Open 2021; 9: E181-E188.
Reference16 Agarwal A, Basmaji J, Muttalib F, Granton D, Chaudhuri D, Chetan D, et al. High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission. Can J Anaesth 2020; 67: 1217-48.
Reference17 Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, et al.; and the Emory COVID-19 Quality and Clinical Research Collaborative. ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019. Crit Care Med. 2020; 48: e799-e804.
Reference18 Guney BC, Hayiroglu M, Senocak D, Cİcek V, Cinar T, Kaplan M. Evaluation of N/LP Ratio as a Predictor of Disease Progression and Mortality in COVID-19 Patients Admitted to the Intensive Care Unit. Medeniyet Med J 2021; 36: 241-8.
Reference19 Pijls BG, Jolani S, Atherley A, Derckx RT, Dijkstra JIR, Franssen GHL, et al. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ Open. 2021;11:e044640.