Department of Anesthesiology and Critical Care Unit, Başkent University Faculty of Medicine, Ankara, Turkey.
Bosn J Basic Med Sci. 2022 Apr 1;22(2):261-269. doi: 10.17305/bjbms.2021.6657.
The decrease in social distance together with the normalization period as of June 1, 2020 in our country caused an increase in the number of COVID 19 patients. Our aim was to compare the demographic features, clinical courses and outcomes of confirmed and probable coronavirus disease 2019 (COVID-19) patients admitted to our intensive care unit (ICU) during the normalization period. Critically ill 128 COVID-19 patients between June 1 - December 2, 2020 were analyzed retrospectively. The mean age was 69.7±15.5y (61.7% male). Sixty-one patients (47.7%) were confirmed. Dyspnea (75.0%) was the most common symptom and hypertension (71.1%) was the most common comorbidity. The mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score; Glasgow Coma Score (GCS); Sequential Organ Failure Assessment (SOFA) scores on ICU admission were 17.4 ± 8.2, 12.3 ± 3.9 and 5.9 ± 3.4, respectively. 101 patients (78.1%) received low flow oxygen, 48 had high flow oxygen therapy (37.5%) and 59 (46.1%) had invasive mechanical ventilation. 53 patients (41.4%) had vasopressor therapy and 30 (23.4%) patients had renal replacement therapy (RRT) due to acute kidney injury (AKI). Confirmed patients were more tachypneic (p=0.005) and more hypoxemic than probable patients (p<0.001). Acute respiratory distress syndrome (ARDS) and AKI were more common in confirmed patients than probable (both p<0.001). Confirmed patients had higher values of hemoglobin, C- reactive protein, fibrinogen, D-dimer than probables (respectively, p=0.028, 0.006, 0.000, 0.019). The overall mortality was higher in confirmed patients (p=0.209, 52.6% vs 47.4%). Complications are more common among confirmed COVID-19 patients admitted to ICU. The mortality rate of confirmed COVID-19 patients admitted to the ICU was found to be higher than probable patients. Mortality of confirmed cases were higher than prediction of APACHE-II scoring system.
自 2020 年 6 月 1 日起，我国社会距离缩短并进入正常化阶段，导致 COVID-19 患者数量增加。我们的目的是比较在正常化期间入住重症监护病房（ICU）的确诊和可能的 2019 年冠状病毒病（COVID-19）患者的人口统计学特征、临床病程和结局。回顾性分析了 2020 年 6 月 1 日至 12 月 2 日期间入住 ICU 的 128 例危重症 COVID-19 患者。患者的平均年龄为 69.7±15.5 岁（61.7%为男性）。61 例（47.7%）为确诊病例。呼吸困难（75.0%）是最常见的症状，高血压（71.1%）是最常见的合并症。入 ICU 时急性生理学和慢性健康评估系统（APACHE II）评分、格拉斯哥昏迷评分（GCS）和序贯器官衰竭评估（SOFA）评分分别为 17.4±8.2、12.3±3.9 和 5.9±3.4。101 例（78.1%）患者接受低流量吸氧，48 例接受高流量氧疗（37.5%），59 例（46.1%）接受有创机械通气。53 例（41.4%）患者接受血管加压治疗，30 例（23.4%）因急性肾损伤（AKI）患者接受肾脏替代治疗（RRT）。与可能的病例相比，确诊病例的呼吸急促（p=0.005）和低氧血症更为严重（p<0.001）。与可能的病例相比，确诊病例的急性呼吸窘迫综合征（ARDS）和 AKI 更为常见（均为 p<0.001）。确诊病例的血红蛋白、C 反应蛋白、纤维蛋白原、D-二聚体值高于可能病例（分别为 p=0.028、0.006、0.000、0.019）。确诊病例的总体死亡率高于可能病例（p=0.209，52.6%比 47.4%）。入住 ICU 的确诊 COVID-19 患者的并发症更为常见。入住 ICU 的确诊 COVID-19 患者的死亡率高于可能病例。确诊病例的死亡率高于 APACHE-II 评分系统的预测。
