Background and Objectives: The aim of this study was to investigate the association between obesity and 28-day mortality, duration of invasive mechanical ventilation and length of stay at the Intensive Care Unit (ICU) and hospital in patients admitted to the ICU for SARS-CoV-2 pneumonia. Materials and Methods: This was a retrospective observational cohort study in patients admitted to the ICU for SARS-CoV-2 pneumonia, in a single Dutch center. The association between obesity (body mass index > 30 kg/m2) and 28-day mortality, duration of invasive mechanical ventilation and length of ICU and hospital stay was investigated. Results: In 121 critically ill patients, pneumonia due to SARS-CoV-2 was confirmed by RT-PCR. Forty-eight patients had obesity (33.5%). The 28-day all-cause mortality was 28.1%. Patients with obesity had no significant difference in 28-day survival in Kaplan–Meier curves (log rank p 0.545) compared with patients without obesity. Obesity made no significant contribution in a multivariate Cox regression model for prediction of 28-day mortality (p = 0.124), but age and the Sequential Organ Failure Assessment (SOFA) score were significant independent factors (p < 0.001 and 0.002, respectively). No statistically significant correlation was observed between obesity and duration of invasive mechanical ventilation and length of ICU and hospital stay. Conclusion: One-third of the patients admitted to the ICU for SARS-CoV-2 pneumonia had obesity. The present study showed no relationship between obesity and 28-day mortality, duration of invasive mechanical ventilation, ICU and hospital length of stay. Further studies are needed to substantiate these findings.
Background: The SARS-CoV-2 pandemic puts patients and their relatives at risk of developing post-intensive care syndrome (PICS and PICS-family). The use of an intensive care unit (ICU) diary for these patients could help fill in memory gaps and complete their fragmented illness narrative. Objectives: The aim of this study is to evaluate the effect of an ICU diary on the occurrence of impaired mental health in patients admitted with a SARS-CoV-2 infection and their relatives. Methods: An observational cohort study of SARS-CoV-2 patients treated in the ICU of Elizabeth-Tweesteden Hospital (ETZ) in Tilburg, The Netherlands will be conducted. Adult patients admitted at the ICU because of respiratory insufficiency due to SARS-CoV-2, who are mechanically ventilated, are included. During treatment in the ICU a diary is kept of the patient. Anxiety, depression and post-traumatic stress disorder, cognitive dysfunction and quality of life will be screened in patients and their relatives by using the psychosocial screening instrument for adult trauma patients (PSIT), the Cognitive Failure Questionnaire (CFQ) and the short-form health survey 36 (SF-36). The recollection of patients’ memory of the ICU stay will be evaluated by the ICU memory tool. The appreciation of the ICU diary will be assessed using a questionnaire. Results: Participants’ characteristics including how they valued the diary, and their memory of ICU treatment will be reported. Multiple logistic regression analysis will be performed for analyzing the relation between mental health outcome and the use of ICU diaries. Change in PICS symptoms over time will be analyzed using longitudinal data analysis. Missing values in questionnaires will be analyzed using missing value analysis and multiple imputations at item level will be performed if necessary. Conclusions: This study will contribute to the knowledge of mental health outcome in SARS-CoV-2 patients and the use of ICU diaries in this group.
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