Mortality in patients with Sars-Cov-2 in intensive care
predictive factors
DOI:
https://doi.org/10.48492/servir0205.29944Keywords:
SARS-CoV-2, Intensive Care, Comorbidity, Risk Factors, MortalityAbstract
Introduction: Worldwide, more than 750 million people have been diagnosed with COVID-19 and nearly 7 million have died. About 80% of those infected are asymptomatic or have only mild symptoms and 6% to 10% require admission to an intensive care unit, where the mortality rate is high (between 30-50%).
Objective/s: To determine the factors influencing mortality in patients hospitalized with SARS-Cov-2 in intensive care at the Tondela-Viseu Hospital Center.
Methods: This is a descriptive, retrospective and correlational cross-sectional cohort study in a non-probabilistic convenience sample of 143 patients with SARS-Cov-2 admitted to intensive care at a central hospital in central Portugal, from 03/17/2020 to 08/31/2021.
Results: The mortality rate was 32.9%, being higher at older ages. The existence of comorbidities was not a predictor of mortality. At the time of admission to the intensive care unit, most individuals were hospitalized (70.6%). The need for invasive mechanical ventilation and the presence of bacterial infections proved to be predictors of higher mortality. The Sequential Organ Failure Assessment, the Simplified Acute Physiology Score and the Acute Physiology And Chronic Health Evaluation were good instruments for predicting mortality. On the other hand, the existence of associated comorbidities was not a predictor of mortality.
Conclusion: The need for continuous monitoring of associated risk factors (need for IMV and presence of bacterial infections) is evidenced in order to better manage their association with increased mortality. This evaluation should be carried out by specialized professionals with in-depth scientific knowledge in the area of intervention.
Downloads
References
Alvear-Vega, S., & Canteros-Gatica, J. (2018). Evaluación del desempeño del APACHE II y SAPS III, en una unidad de cuidados intensivos [Performance evaluation of APACHE II and SAPS III in an intensive care unit]. Revista de Salud Publica (Bogota, Colombia), 20(3), 373–377. doi:10.15446/rsap.V20n3.59952
Auld, S. C., Caridi-Scheible, M., Blum, J. M., Robichaux, C., Kraft, C., Jacob, J. T., ... Carpenter, D. (2020). ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019. Critical Care Medicine, 48(9), e799–e804. doi.:10.1097/CCM.0000000000004457
De Bruyn, A., Verellen, S., Bruckers, L., Geebelen, L., Callebaut, I., De Pauw, I., … Dubois, J. (2022). Secondary infection in COVID-19 critically ill patients: a retrospective single-center evaluation. BMC infectious diseases, 22(1), 207. doi: 10.1186/s12879-022-07192-x
Direção Geral da Saúde. Covid-19. Relatório de Situação nº363 de 28/02/2021. [Acedido no dia 03/01/2023] Recuperado de: https://covid19.min-saude.pt/wp-content/uploads/2022/03/363_DGS_boletim_20210228_pdf-293kb.pdf
Galvão M. H. R., Roncalli A. G. (2020). Fatores associados a maior risco de ocorrência de óbito por COVID-19: análise de sobrevivência com base em casos confirmados. Revista Brasileira de Epidemiologia [Acedido em 9 de nov. 2022] Recuperado de: https://doi.org/10.1590/1980-549720200106.
Giannouchos, Theodoros V., Sussman Roberto A., Mier José M., Poulas K., Farsalinos K. Characteristics and risk factors for COVID-19 diagnosis and adverse outcomes in Mexico: an analysis of 89,756 laboratory-confirmed COVID-19 cases. (2021). The European Respiratory Journal, 57(3), 2002144. Doi:10.1183/13993003.02144-2020
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. doi: 10.1016/S0140-6736(20)30183-5
Loss, S. H., Luce, D. C., & Capellari, G. (2022). Characteristics and outcomes of COVID-19 patients assisted by intensivists and nonintensivists. Revista da Associacao Medica Brasileira (1992), 68(9), 1204–1209. doi:10.1590/1806-9282.20220200
Mendes, J. J., Silva, M. J., Miguel, L. S., Gonçalves, M. A., Oliveira, M. J., Oliveira, C. D. L., & Gouveia, J. (2019). Sociedade Portuguesa de Cuidados Intensivos guidelines for stress ulcer prophylaxis in the intensive care unit. Diretrizes da Sociedade Portuguesa de Cuidados Intensivos para profilaxia da úlcera de estresse na unidade de terapia intensiva. Revista Brasileira de Terapia Intensiva, 31(1), 5–14. doi:10.5935/0103-507X.20190002
Nyasulu, P. S., Ayele, B. T., Koegelenberg, C. F., Irusen, E., Lalla, U., Davids, R., … Allwood, B. W. (2022). Clinical characteristics associated with mortality of COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa. PloS one, 17(12), e0279565. Doi:10.1371/journal.pone.0279565
Fuchs, P. A., Czech, I. J., & Krzych, Ł. J. (2020). Mortality Prediction Using SOFA Score in Critically Ill Surgical and Non-Surgical Patients: Which Parameter Is the Most Valuable?. Medicina (Kaunas, Lithuania), 56(6), 273. doi:10.3390/medicina56060273
Pouwels, S., Ramnarain, D., Aupers, E., Rutjes-Weurding, L., & van Oers, J. (2021). Obesity May Not Be Associated with 28-Day Mortality, Duration of Invasive Mechanical Ventilation and Length of Intensive Care Unit and Hospital Stay in Critically Ill Patients with Severe Acute Respiratory Syndrome Coronavirus-2: A Retrospective Cohort Study. Medicina (Kaunas, Lithuania), 57(7), 674. doi: 10.3390/medicina57070674.
Roomi, S., Shah, S. O., Ullah, W., Abedin, S. U., Butler, K., Schiers, K., … Jallo, J. (2021). Declining Intensive Care Unit Mortality of COVID-19: A Multi-Center Study. Journal of Clinical Medicine Research, 13(3), 184–190. doi: 10.14740/jocmr4452.
Suarez-de-la-Rica, A., Serrano, P., De-la-Oliva, R., Sánchez-Díaz, P., Molinero, P., Falces-Romero, I., … Maseda, E. (2021). Secondary infections in mechanically ventilated patients with COVID-19: An overlooked matter?. Revista Espanola de Quimioterapia :Publicacion Oficial de la Sociedad Espanola de Quimioterapia, 34(4), 330–336. doi:10.37201/req/031.2021.
Synowiec, A., Szczepański, A., Barreto-Duran, E., Lie, L. K., & Pyrc, K. (2021). Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection. Clinical Microbiology Reviews, 34(2), e00133-20. doi:10.1128/CMR.00133-20
World Health Organization. Coronavirus (COVID-19) Dashboard. [Acedido no dia 18/04/2023] Recuperado de: https://covid19.who.int/
Zhang, H., Zhang, Y., Wu, J., Li, Y., Zhou, X., Li, X., … Zhang, W. (2020). Risks and features of secondary infections in severe and critical ill COVID-19 patients. Emerging Microbes & Infections, 9(1), 1958–1964. doi:10.1080/22221751.2020.1812437
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., … Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England), 395(10229), 1054–1062. DOI: 10.1016/S0140-6736(20)30566-3.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Helder Patrício
This work is licensed under a Creative Commons Attribution 4.0 International License.
In order to promote the free circulation of knowledge, Servir is open access journal. All its content is available and protected under the Creative Commons license (CC BY 4.0).
The journal allows self-archiving in institutional repositories of all versions, which may become immediately available
