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Evaluation of Patients Treated in Intensıve Care Due to COVID-19: A Retrospective Study
Gökhan Kılınç1, Aslı Akcan Atasoy2
1Department of Anesthesiology and Reanimation Intensive Care, Balıkesir Atatürk City Hospital, Balıkesir, Turkey. gkilinc35@hotmail.com.
Insights
Critically ill patients with COVID-19 pneumonia had a high mortality rate of 69.5%. Older age, high Sequential Organ Failure Assessment (SOFA) scores, elevated d-dimer levels, and diabetes mellitus were associated with increased mortality risk.
Area of Science:
- Intensive Care Medicine
- Infectious Diseases
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) poses significant challenges in intensive care settings.
- Understanding factors influencing mortality in critically ill COVID-19 patients is crucial for improving outcomes.
Purpose of the Study:
- To analyze demographic, clinical, and laboratory factors associated with mortality in intensive care unit (ICU) patients with COVID-19.
- To identify predictors of death in critically ill COVID-19 patients.
Main Methods:
- Retrospective cohort study of adult COVID-19 patients in a tertiary hospital ICU.
- Univariate and multivariate logistic regression analyses were used to identify independent predictors of survival.
Main Results:
- The overall mortality rate was 69.5% among 200 critically ill COVID-19 patients.
- Factors significantly associated with increased mortality included older age, higher heart rate, elevated white blood cell counts, high neutrophil/lymphocyte ratio, increased d-dimer, ferritin, C-reactive protein (CRP), APACHE II score, and Sequential Organ Failure Assessment (SOFA) score.
- Multivariate analysis identified positive reverse transcriptase-polymerase chain reaction (RT-PCR) test, older age, higher heart rate, higher SOFA score, high d-dimer levels at admission, and diabetes mellitus as independent predictors of death.
Conclusions:
- Critically ill COVID-19 patients exhibit high mortality.
- Older age, acute respiratory distress syndrome, high SOFA scores, elevated d-dimer levels upon admission, and the presence of diabetes mellitus are associated with increased mortality risk.
Background:
The aim of this study is to report the demographic characteristics, clinical features, treatment protocols, comorbidities, imaging findings, prognosis and factors affecting mortality in critically ill patients with coronavirus disease 2019 (COVID-19) in the intensive care unit.
Materials And Methods:
This retrospective cohort study consists of adult (≥18 years old) patients hospitalized in a tertiary hospital intensive care unit of with COVID-19. The independent effects of possible factors identified in previous analyzes on survival were analyzed using univariate and multivariate logistic regression analysis.
Results:
The mean age of all patients was 70.2 ± 13.9 years. Of the 200 patients, 139 (69.5%) had died. White blood cells (19.2 ± 76.1 × 109 per L), neutrophil/lymphocyte ratio (15.4 ± 65.1), d-dimer (2,558.4 ± 4,574.2 ng/mL), ferritin (1,481.2 ± 4,447.4 μg/L) and C-reactive protein (CRP) (12.1 ± 11.9 mg/dL) levels were high at the time of admission. According to the results of univariate regression analysis; presence of additional disease (odds ratio [OR]: 3.837; P = 0.015), older age (OR: 1.027; P = 0.015), reverse transcriptase-polymerase chain reaction (RT-PCR) positivity (OR: 2.58; P = 0.019), higher heart rate (OR = 1.027; P = 0.028), higher APACHE II score (OR: 1.049; P = 0.012), higher sequential organ failure assessement (SOFA) score(OR: 1.479; P = 0.014), high d-dimer levels (OR: 3.180; P <0.001) and high CRP levels (OR: 1.035; P = 0.028) increases the risk of death. When patients with full data for all variables in the multivariate logistic regression model were evaluated; positive RT-PCR (OR=4.105; P = 0.005), older age (OR: 1.033; P = 0.024), higher heart rate (OR: 1.042; P = 0.006), higher (SOFA) score (OR: 1.477; P <0.001), high d-dimer levels at admission (OR: 3.459; P = 0.002) and diabetes mellitus (OR: 3.433; P = 0.035) increase the risk of death.
Conclusion:
Mortality of critically ill patients with COVID-19 pneumonia was high (69.5%). Older patients and acute respiratory distress syndrome were at higher risk of death. High SOFA score, high d-dimer at admission, and presence of diabetes mellitus were associated with high mortality.
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