학술논문
Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Clinical report
Author
Sili, Uluhan; Ay, Pinar; Topuzoglu, Ahmet; Bilgin, Huseyin; Tukenmez-Tigen, Elif; Erturk-Sengel, Buket; Yagci- Caglayik, Dilek; Balcan, Baran; Kocakaya, Derya; Olgun-Yildizeli, Sehnaz; Gul, Fethi; Bilgili, Beliz; Can-Sarinoglu, Rabia; Karahasan-Yagci, Aysegul; Mulazimoglu-Durmusoglu, Lutfiye; Eryuksel, Emel; Odabasi, Zekaver; Direskeneli, Haner; Karakurt, Sait; Cinel, Ismail; Korten, Volkan
Source
Infectious Diseases and Clinical Microbiology. June 2023, Vol. 5 Issue 2, p94, 12 p.
Subject
Language
English
ISSN
2667-646X
Abstract
INTRODUCTION The first coronavirus disease 2019 (COVID-19) case in Turkey was reported on March 11, 2020 (1). The number of confirmed cases with symptoms increased afterward, reaching 5000 per day [...]
Objective: This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. Materials and Methods: We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. Results: The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p Conclusion: Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced. Keywords: COVID-19, prospective cohort, critical illness, prognosis Graphic Abstract What are the factors associated with 28-day critical illness development during the first COVID-19 wave? What did we do? A prospective cohort study in a tertiary care center was conducted from March-May 2020 Patients admitted to the hospital with COVID-19 were included consequtively (n=477) Main outcome was critical illness development (invasive mechanical ventilation or death) within 28 days What did we find? 9.4% Critical illness 61 patients (12.8%) were admitted to ICU 40 patients (8.4%) were intubated 34 patients (7.1%) died Overall 45 patients (9.4%) developed critical illness Factors associated with critical illness Increasing age and comorbidities The WHO scale for clinical improvement The period of admission High LDH and procalcitonin Conclusion The WHO scale on admission was the strongest predictor of critical illness (HR=4.15, p Patients hospitalized at the end of the study period had a much better prognosis compared the patients hospitalized at the beginning (HR=0.14, p Our findings will be useful for comparison to the other waves of COVID-19.
Objective: This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. Materials and Methods: We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. Results: The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p Conclusion: Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced. Keywords: COVID-19, prospective cohort, critical illness, prognosis Graphic Abstract What are the factors associated with 28-day critical illness development during the first COVID-19 wave? What did we do? A prospective cohort study in a tertiary care center was conducted from March-May 2020 Patients admitted to the hospital with COVID-19 were included consequtively (n=477) Main outcome was critical illness development (invasive mechanical ventilation or death) within 28 days What did we find? 9.4% Critical illness 61 patients (12.8%) were admitted to ICU 40 patients (8.4%) were intubated 34 patients (7.1%) died Overall 45 patients (9.4%) developed critical illness Factors associated with critical illness Increasing age and comorbidities The WHO scale for clinical improvement The period of admission High LDH and procalcitonin Conclusion The WHO scale on admission was the strongest predictor of critical illness (HR=4.15, p Patients hospitalized at the end of the study period had a much better prognosis compared the patients hospitalized at the beginning (HR=0.14, p Our findings will be useful for comparison to the other waves of COVID-19.