Ülkü İNCE, Harun Tolga DURAN, Yusuf YİLDİRİM, Sule GOKCE

The Effect of Co-Morbid Diseases on The Need for Mechanical Ventilation and Mortality of Patients with Covid-19 in Intensive Care Unit

It is aimed to contribute to the literature on Covid 19, a new disease, by examining the mechanical ventilation support, mortality and factors affecting them during the follow-up of patients infected with Covid 19 in the intensive care unit. The clinical course of covid 19 infected patients who were hospitalized in the intensive care unit between March 30 and October 30, 2020, such as length of stay, additional diseases, mechanical ventilation support and mortality rates, were analyzed retrospectively and compared. 66 of 100 patients included in the study required invasive mechanical ventilation, 34 of them did not. The probability of having two or more comorbidities was significantly higher in patients requiring invasive mechanical ventilation (P:0,007). The motrality rate was 64% among all patients. Advanced age and additional systemic diseases increase mortality in patients infected with Covid19 treated in intensive care. We believe that patients of advanced age and 2 and above with additional systemic diseases need more invasive mechanical ventilation support and that adequate clinical improvement cannot always be achieved with high flow nasal oxigenation (HFNO) and invasive mechanical ventilation (IMV) support applications in these patients.

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Fei Zhou, Ting Yu, Ronghui Du, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.

Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30:]. Lancet. 2020;395:497–506.

Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020.

Puah SH. ATS and APSR Joint Webinar: Global perspectives on COVID-19. https://www.apsresp.org/ archive/2020-covid-19-webinar.html 27.03.2020

Zhou F, Yu T, Du R, et al. Clinical courseand risk factorsfor mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62.

Inglis R, Ayebale E, Schultz MJ, 2019. Optimizing respiratory management in resource-limited settings. Curr Opin Crit Care. 25:45–53.

Ayebare RR, Flick R, Okware S, et al, 2020. Adoption of COVID-19 triage strategies for low-income settings. Lancet Respir Med. 8:e22.

Spoletini G, Alotaibi M, Blasi F, et al. Heated humidified high-flow nasal oxygen in adults: mechanisms of action and clinical implications Chest. 2015;148:253-61.

Raoof S, Nava S, Carpati C, et al. High-Flow, noninvasive ventilation and awake (nonintubation) proning in patients with coronavirus disease 2019 with respiratory failure Chest. 2020;158:1992-2002.

Peng PWH, Ho P., Outbreak of a new coronavirus: what anaesthetists should know. Br J Anaesth. 2020;395:470–3.

Wax RS, Christian MD Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients Can J Anaesth. 2020;67:568-76.

Leung CCH, Joynt GM, Gomersall CD Comparison of high-flow nasal cannula versus oxygen face mask for environmental bacterial contamination in critically ill pneumonia patients: a randomized controlled crossover trial . J HospInfect. 2019;101:84–7.

Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome Lancet Respir Med. 2020;8:420–2.

Albitar O, Ballouze R, Ooi JP, et al. Risk factors for mortality among COVID-19 patients. Diabetes Res Clin Pract. 2020;166:108293.

Palmieri L, Vanacore N, Donfrancesco C, et al Clinical characteristics of hospitalized individuals dying with COVID-19 by age group in Italy Journals of Gerontology: Medical Sciences cite as: J Gerontol A Biol Sci Med Sci. 2020;75:1796–800.

Guan WJ, Liang WH, ZhaoY, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55:2000547.

Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of Covid-19 in New York City. N Engl J Med. 2020;382:2372–4.

Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323:2052–9.

Cheung TM, Yam LY, So LK, et al. Effectiveness of noninvasive positive pressure ventilation in the treatment of acute respiratory failure in severe acute respiratory syndrome. Chest. 2004;126:845–50.