Ashraf Mohammad Ali, Sherafat Alireza, Naderi Zohre, Sami Ramin, Soltaninejad Forogh, Khodadadi Saba, Mashayekhbakhsh Sanaz, Sharafi Negar, Ahmadi Somayeh Haji, Shayganfar Azin, Zand Iman, Ajami Ali, Shirani Kiana
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Undergraduate, School of Medicine, University of Central Lancashire, Preston, United Kingdom.
J Res Med Sci. 2022 Apr 15;27:34. doi: 10.4103/jrms.JRMS_1213_20. eCollection 2022.
Since the beginning of the coronavirus disease of 2019 (COVID-19) pandemic, concerns raised by the growing number of deaths worldwide. Acute respiratory distress syndrome (ARDS) and extrapulmonary complications can correlate with prognosis in COVID-19 patients. This study evaluated the association of systemic complications with mortality in severely affected COVID-19 patients.
This retrospective study was done on 51 intensive care unit (ICU)-admitted COVID-19 adult patients who were admitted to the ICU ward of Khorshid hospital, affiliated with Isfahan University of Medical Sciences. Only the patients who had a definite hospitalization outcome (dead vs. survivors) were included in the study. Daily clinical and paraclinical records were used to diagnose in-hospital complications in these patients.
The sample was comprised of 37 males (72.5%) and 14 females (27.4%). The median age of patients was 63 years (Min: 20, Max: 84), with the mortality rate of 47.1%. In total, 70.6% of patients had at least one coexisting disorder. Chronic kidney disease was associated with the worse outcome (29.16% of dead patients against 3.70 of survived ones). Mechanical ventilation was used in 58.8% of patients. Patients who had received invasive ventilation were more likely to die (87.50% of dead patients against 7.40 of survivors), Complications including sepsis and secondary infections (odds ratio: 8.05, confidence interval: 2.11-30.63) was the strongest predictors of mortality.
Complications including sepsis and secondary infections can increase the risk of death in ICU-admitted COVID-19 patients. Therefore, it is substantial that the physicians consider preventing or controlling these complications.
自2019冠状病毒病（COVID-19）大流行开始以来，全球死亡人数不断增加引发了人们的担忧。急性呼吸窘迫综合征（ARDS）和肺外并发症可能与COVID-19患者的预后相关。本研究评估了重症COVID-19患者全身并发症与死亡率之间的关联。
本回顾性研究针对51名入住设拉子医科大学附属霍尔希德医院重症监护病房（ICU）的成年COVID-19患者进行。只有具有明确住院结局（死亡与存活）的患者被纳入研究。通过每日临床和辅助检查记录来诊断这些患者的院内并发症。
样本包括37名男性（72.5%）和14名女性（27.4%）。患者的中位年龄为63岁（最小：20岁，最大：84岁），死亡率为47.1%。总体而言，70.6%的患者至少有一种并存疾病。慢性肾脏病与更差的结局相关（死亡患者中有29.16%患有慢性肾脏病，而存活患者中这一比例为3.70%）。58.8%的患者使用了机械通气。接受有创通气的患者死亡可能性更大（死亡患者中有87.50%接受了有创通气，而存活患者中这一比例为7.40%），包括脓毒症和继发感染在内的并发症（优势比：8.05，置信区间：2.11 - 30.63）是死亡率的最强预测因素。
包括脓毒症和继发感染在内的并发症会增加入住ICU 的COVID-19患者的死亡风险。因此，医生考虑预防或控制这些并发症至关重要。
