Tuğçe ŞAHİN ÖZDEMİREL, Esma Sevil AKKURT, Özlem ERTAN, Mehmet Enes GÖKLER, Berna AKINCI ÖZYÜREK

Complications with moderate-to-severe COVID-19 during hospital admissions in patients with pneumonia

Introduction: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is an infectious disease that has caused significant mortality and morbidity worldwide. COVID-19 is known to cause complications, such as myocardial damage, acute coronary syndrome, deep vein thrombosis, pulmonary embolism, arrhythmia, heart failure, acute ischemic stroke, liver damage, cytokine storms, ischemia-reperfusion damage and side effects of drug treatments. In our study, we aimed to evaluate the complications that developed during hospitalizations in patients with moderate-to-severe COVID-19 related pneumonia who were hospitalized in our COVID-19 service. Material and Method: This study included patients with moderate-to-severe COVID-19 pneumonia with a positive reverse transcriptase polymerase chain reaction (RT-PCR) test who were treated in our COVID-19 service between November 2020 and January 2021. Their demographic characteristics, treatment regimens, baseline laboratory values and complications during their hospitalization were retrospectively recorded. Results: The study group had a mean age of 62.92± 14.60 years and 40.6% (n= 55) were female. Approximately 35.3% (n= 48) of the patients developed complications due to COVID-19 during their follow-up period. Of the patients with complications, 63.8% (n: 30) were male, most common complications were elevated liver enzymes (47.9%) and pulmonary thromboembolism (20.8%). Of those patients with complications, the most common comorbidities were hypertension (40.4% [n= 19]), diabetes mellitus (25.5% [n=12]) and cardiovascular disease (23.4% [n=11]). There were no significant relationships between the presence of complications and age, sex or comorbid diseases (p>0.05 for each). Conclusion: There are more underlying conditions, such as hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease in hospitalized patients with moderate-to-severe pneumonia compared to outpatients with COVID-19 pneumonia. Complications develop, especially in the management of COVID-19 pneumonia, which affect the treatment process and patient mobilization.

Keywords:

complication, COVID-19, pneumonia,

PDF

___

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with CO- VID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
Du Toit A. Outbreak of a novel coronavirus. Nat Rev Microbiol 2020; 18: 123.
European Centre for Disease Prevention and Control. Q & A on COVID-19: Basic facts. Available from: https://www. ecdc.europa.eu/en/covid-19/facts/questions-answersbasic-facts Accessed date: 18 Sept 2020.
Mahajan P, Dass B, Radhakrishnan N, McCullough PA. COVID-19-Associated Systemic Thromboembolism: A Case Report and Review of the Literature. Cardiorenal Med 2020; 10: 462-9.
Boukhris M, Hillani A, Moroni F, et al. Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective. Can J Cardiol 2020; 36: 1068-80.
Tian D, Ye Q. Hepatic complications of COVID-19 and its treatment. J Med Virol 2020; 92: 1818-24.
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
Zantah M, Dominguez Castillo E, Townsend R, Dikengil F, Criner GJ. Pneumothorax in COVID-19 disease- incidence and clinical characteristics. Respir Res 2020; 21: 236.
Jin JM, Bai P, He W, et al. Gender differences in patients with COVID-19: focus on severity and mortality. Front Public Health 2020; 8: 152.
Qiu P, Zhou Y, Wang F, et al. Clinical characteristics, laboratory outcome characteristics, comorbidities, and complications of related COVID-19 deceased: a systematic review and meta-analysis. Aging Clin Exp Res 2020; 32: 1869-78.
Bertolini A, Van de Peppel IP, Bodewes FAJA, Moshage H, Fantin A, Farinati F. Abnormal liver function tests in patients with COVID-19: Relevance and Potential Pathogenesis. Hepatology 2020; 72: 1864-72.
Zhang Y, Zheng L, Liu L, Zhao M, Xiao J, Zhao Q. Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China. Liver Int 2020; 40: 2095-103.
Cai Q, Huang D, Yu H, et al. COVID-19: Abnormal liver function tests. J Hepatol 2020; 73: 566-74.
Fan Z, Chen L, Li J, et al. Clinical features of COVID-19-related liver damage. Clin Gastroenterol Hepatol 2020; 18: 1561-6.
Porfidia A, Valeriani E, Pola R, Porreca E, Rutjes A, Di Nisio M. Venous thromboembolism in patients with COVID-19: Systematic review and meta-analysis. Thrombosis research 2020; 196: 67-74.
Boonyawat K, Chantrathammachart P, Numthavaj P, et al. Incidence of thromboembolism in patients with COVID-19: a systematic review and meta-analysis. Thrombosis Journal 2020: 23; 18: 34.
Bompard F, Monnier H, Saab I et al. Pulmonary embolism in patients with COVID-19 pneumonia. Eur Respir J. 2020; 56: 2001365.
Xu Y, Qian Y, Gu Q, et al. Relationship between d-dimer concentration and inflammatory factors or organ function in patients with coronavirus disease 2019. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2020; 32: 559–63.
Li Y, Zhao K, Wei H, et al. Dynamic relationship between d-dimer and COVID-19 severity. Br J Haematol 2020; 190: e24–7.
Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020 Aug;18(8):1995-2002.
Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 2020; 191: 9.
Sun R, Liu H, Wang X. Mediastinal emphysema, Giant Bulla and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol 2020; 21: 541-44.
Liu K, Zeng Y, Xie P, et al. COVID-19 with cystic features on computed tomography: A case report. Medicine (Baltimore) 2020; 99: e20175.
Mohan S, Workman A, Barshak M, Welling DB, Abdul-Aziz D. Considerations in Management of Acute Otitis Media in the COVID-19 Era. Ann Otol Rhinol Laryngol 2021; 130: 520-27.
Fidan V. New type of corona virus induced acute otitis media in adult. Am J Otolaryngol 2020; 41: 102487.
Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020; 77: 683-90.
Li Y, Li M, Wang M, et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke Vasc Neurol 2020; 5: 279-84.