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Clinical characteristics, comorbidities and mortality in critically ill mechanically ventilated patients with Covid-19: a retrospective observational study

By
Adisa Šabanović Adilović Orcid logo ,
Adisa Šabanović Adilović
Contact Adisa Šabanović Adilović

Department of Anaesthesiology and Intensive Care Unit, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina

Nermina Rizvanović ,
Nermina Rizvanović

Department of Anaesthesiology and Intensive Care Unit,, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina

Mirza Kovačević ,
Mirza Kovačević

Department of Anaesthesiology and Intensive Care Unit, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina

Harun Adilović
Harun Adilović

Department of Internal Medicine, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina

Abstract

Aim
To analyse demographic data, clinical symptoms and signs, laboratory data and comorbidities in patients with COVID-19 pneumonia admitted to the intensive care unit (ICU), mechanically ventilated with fatal outcome.
Methods
Medical records of 92 patients were retrospectively analysed. Demographic data, clinical symptoms and comorbidities
were collected on the day of hospital admission. Clinical signs and laboratory data were collected on the day of hospital admission (T1), on the day of starting non-invasive ventilation (T2), and on the day of starting invasive ventilation (T3).
Results
Average age of the patients was 60.05 years. Patients over 50 years of age, 71 (77.1%) (p=0.000), and males, 62 (67.4%;
p=0.001) were predominant. The most common patient symptoms were exhaustion, myalgia, dyspnoea and cough. Hyperthermia was recorded on the day of hospital admission. Tachycardia, hyperglycaemia, hypoxemia were recorded at all observed study times. The most common comorbidity was hypertension arterialis with a very strong correlation with fatal outcome, followed by diabetes mellitus and chronic heart disease that were moderately correlated with fatal outcome.
Conclusion
The treatment of COVID-19 patients in ICU with mechanical ventilation has a high failure rate. Demographic data,
clinical symptoms and signs as well as accompanying comorbidities can be a significant component in making decisions about diagnostic-therapeutic procedures.

References

1.
Lu H, Stratton C, Tang Y. Outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. J Med Virol. 2020;401–2.
2.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan. JAMA. 2020;1061–9.
3.
Baloch S, Baloch A, Zheng M, T, Pei. The coronavirus disease 2019 (COVID-19) pandemic. Tohoku. J Exp Med. 2020;271–8.
4.
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. Lancet Respir Med. 2020;475–81.
5.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneu-monia in Wuhan, China: a descriptive study. Lancet. 2020;507–13.
6.
Mcaloon C, Collins Á, Hunt K, Barber A, Byrne A, Butler F, et al. The incubation period of COVID-19: A rapid systematic review and meta-analysis of observational research. BMJ Open. 2020;39652.
7.
Santus P, Radovanovic D, Saderi L, Marino P, Cogliati C, Filippis D, et al. Severity of respiratory failure at admission and in-hospital mortality in patients with COVID-19: a prospective observational multicentre study. BMJ Open. 2020;43651.
8.
Gibson P, Qin L, Puah S. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020;54–6.
9.
Grasselli G, Cattaneo E, Florio G, Ippolito M, Zanella A, Cortegiani A, et al. Mechanical ventilation parameters in critically ill CO-VID-19 patients: a scoping review. Crit Care. 2021;115.
10.
Lepper P, Muellenbach R. Mechanical ventilation in early COVID-19 ARDS. EClinicalMedicine. 2020;100616.
11.
Macedo A, Gonã §alves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Ann Epidemol. 2021;14–21.
12.
Zádori N, Váncsa S, Farkas N, Hegyi P, Eross BKS, Group. The negative impact of comorbidities on the disease course of COVID-19. Intensive Care Med. 2020;1784–6.
13.
Sa NS. Respiratory support for patients with COVID-19 infection. Lancet Respir Med. 2020;18.
14.
Chawla R, Nasa P. Ventilatory management of CO-VID-19-related ARDS: stick to basics and infection control. Indian J Crit Care Med. 2020;609–10.
15.
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;1708–20.
16.
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;1574–81.
17.
Van Halem K, Bruyndonck R, Van Der Hilst J, Cox J, Driesen P, Opsomer M, et al. Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study. BMC Infect Dis. 2020;897.
18.
Auld S, Caridi-Scheible M, Blum J, Robichaux C, Kraft C, Jacob J, et al. Emory COVID-19 Quality and Clinical Research Collaborative. ICU and ventilator mortality among critically ill adults with coronavirus disease 2019. Crit Care Med. 2020;e804.
19.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan. China Lancet. 2020;497–506.
20.
Baj J, Karakuła-Juchnowicz H, Teresinski G, Buszewicz G, Ciesielka M, Sitarz E, et al. COVID-19: specific and non-specific clinical manifestations and symptoms: the current state of knowledge. J Clin Med. 2020;1753.
21.
Conci S, Ruzzenente A, Donadello K, Cybulski A, Pedrazzani C, Campagnaro T, et al. Haemodynamic instability in a critically ill patient with covid-19 pneumonia: searching over the chest -report of a clinical case and mini-review of the literature. Case Rep Imag Surg. 2020;1–3.
22.
Bhandari S, Rankawat G, Singh A. Impact of glycemic control in diabetes mellitus on management of COVID-19 infection. Int J Diabetes Dev Ctries. 2020;340–5.
23.
Singh A, Singh R. Hyperglycemia without diabetes and new-onset diabetes are both associated with poorer outcomes in COVID-19. Diabetes Res Clin Pract. 2020;108382.
24.
Batah S, Fabro A. Pulmonary pathology of ARDS in COVID-19: a pathological review for clinicians. Respir Med. 2021;106239.
25.
Franks T, Chong P, Chui P, Galvin P, Lourens J, Reid R, et al. Lung pathology of severe acute respiratory syndrome (SARS): a study of 8 autopsy cases from Singapore. Hum Pathol. 2003;743–8.
26.
Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its impact on patients with CO-VID-19. SN Compr Clin Med. 2020;1–8.
27.
Harrisonsl F, Eynullayeva E, Lane D, Underhill P, Lip G. Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: a federated electronic medical record analysis. PLoS Med. 2020;1003321.
28.
Du Y, Zhou N, Zha W, Lv Y. Hypertension is a clinically important risk factor for critical illness and mortality in COVID-19: a metaanalysis. Nutr Metab Cardiovasc Dis. :745–55.
29.
Seiglie J, Platt J, Cromer S, Bunda B, Foulkes A, Bassett I, et al. Diabetes as a risk factor for poor early outcomes in patients hospitalized with COVID-19. Diabetes Care. 2020;2938–44.
30.
Leung J, Niikura M, Yang C, Sin D. COVID-19 and COPD. Eur Respir J. 2020;
31.
Guan WJ, Liang WH, Shi Y, Gan LX, Wang HB, He JX, et al. Chronic respiratory diseases and the outcomes of COVID-19: a nationwide retrospective cohort study of 39,420 cases. J Allergy Clin Immunol Pract. 2021;
32.
Phelps M, Christensen M, Gerds T, Fosbøl E, Torp-Pedersen C, Schou M, et al. Cardiovascular comorbidities as predictors for severe COVID-19 infection or death. Eur Heart J Qual Care Clin Outcomes. 2021;172–80.
33.
Kummer B, Klang E, Stein L, Dhamoon M, Jetté N. History of stroke is independently associated with in-hospital death in patients with COVID-19. Stroke. 2020;3112–4.

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